Downton Hospital
by beckyhughes
Summary: Modern AU — Grey's Anatomy, ER, House MD and all your favorite Downton Abbey characters (including the dead ones!) Kind of a Chelsie heavy tale but there's plenty of Cobert, Banna, Richobel and Baxley tossed in for good measure. Lots of medical drama, cussing and even some sexytimes. Stays close to canon in terms of major events, just transplanted into a modern setting! Spoiler-y?
1. First Do No Harm

**Introduction:**

_The legacy of the Crawley family and Downton Hospital goes back generations, as do the secrets contained within the rooms of Yorkshire's finest medical facility. From humble beginnings as a cottage hospital, the modern day level one trauma center boasts some of the most well respected medical staff in Europe and accepts only the finest interns from the world's top medical schools._

_Presiding over the legacy of the hospital is _Dr. Violet Crawley, a retired surgeon who is now the President of the Board of Trustee_s. Sidestepping any accusations of nepotism, she kept the Crawley family legacy tightly entwined with Downton Hospital, appointing her son _Robert as Dean of Medicine.

_One major deciding factor in this arrangement had not to do with Robert's aspirations in medicine so much as his personal conquests: his wife, _Cora, an American heiress, brought an endowment that saved Downton Hospital after the last recession._ They have three daughters — the _eldest, Mary, is Chief Resident in the hospital's surgical department,_ having graduated at the top of her class there was no doubt in anyone's mind that she would lead the next generation of physicians at Downton .The only thing that could threaten her reign?_ Dr. Matthew Crawley — surgical attending,whose mother Isobel is a nurse in the office of Dr. Richard Clarkson,_ the hospital's top general practitioner with an important seat on the board._

Edith, the middle daughter, has just joined the psychiatry team as an intern_. Her aunt _Rosamund (Robert's sister) is Chief of Psychiatry_, and Edith's decision to pursue the specialty was heavily influenced by her close relationship to her._

_The youngest Crawley girl, _Sybil, is still in medical school_ — and let's just say she's not exactly sure that she wants the life her family has set up for her. What she does want, however, is the attention of a certain_ ambulance driver/EMT named Tommy Branson.

_Drama abounds within the hospital walls when _Chief of Surgery Dr. Charles Carson _presides over his many young physicians — Mary Crawley, of course, as his protege. A man of order and routine, he can only ever be tempted out of his office or the OR by his oldest friend, _Chief of Pediatrics Dr. Elsie Hughes_. The two have been sharing coffee in one another's office during the night shift for decades — neither has ever married, choosing instead to commit wholly to their careers — and Downton Hospital. As they near retirement and change drives them away from the hospital, from the only lives they've ever known, will they find solace in one another?_

_Dr. Hughes' only friend, aside from Dr. Carson, is_ Beryl Patmore RN, BSN, the nursing supervisor._ Nurse Patmore is a tough cookie, but she has known Dr. Hughes since she was just a resident. They've seen a lot over the years and both know that while they might be women of hard exteriors, they've got hearts of gold. Nurse Patmore and Dr. Hughes preside over the nursing staff on the pediatric ward, which includes fresh nursing intern _Daisy, nurse Anna Smith, pediatric anesthesia resident John Bates (_who are often caught canoodling in the locker room) _and Phyllis Baxter, a sweet nurse who is hiding a terrible secret and Joe Molesley, the only male nurse on the unit who happens to have a sizeable crush on Nurse Baxter.

_All might seem to be going rather well at Downton Hospital, but if you look closely you'll see two shadowy figures chain-smoking on the roof. That's_Thomas Barrow and Sarah O'Brien_ —while they may at first appear to be quiet and unassuming_ unit secretaries_, the pair are hatching a plan to bring Downton Hospital down— one unit at a time._

* * *

**Chapter One: First, Do No Harm**

The first thing Dr. Elsie Hughes did when she closed the door to her office was kick off her shoes. Why, at sixty-two, she still insisted on wearing heels to rounds she couldn't say. She hadn't even fully crossed the room to her desk before she kicked off one, hobbling across the oriental carpet as she reached down to remove the other. Shoving them under her desk and sitting down, at last, she exhaled deeply. Three quick knocks at the door — _oh, how infrequent were her uninterrupted hours! —_ kept her from taking any more pause.

"Yes?" she said, checking her watch. 6:34 am.

He was four minutes late.

Dr. Charles Carson, Chief of Surgery, had been bringing her coffee every morning after rounds for the last fifteen years. Prior to that, they had shared coffee in other various locations around Downton Hospital. Stairwells, the doctor's lounge, the occasional gurney in the ER hallway. When she had come to Downton Hospital to complete her residency, he had already been at the hospital a solid decade. He was always rather chuffed to remind his interns that he had been born at Downton Cottage Hospital — the precursor to the modernized and internationally revered Downton Hospital. Downton, he would tell them, was his bloodline.

The only thing keeping him from being Dean of Medicine was that he couldn't stand the thought of leaving the OR. The Dean's job, more of a figurehead position, included more paperwork than he felt comfortable with. And, of course, despite the fact that he was well-liked by the hospital's President, the "right honorable Dr. Violet Crawley" he hadn't had a snowflake's chance in hell once she'd got it into her head that her son should preside as Dean.

He'd managed to shrug it off. Truth be told, he was hoping he'd die in the OR. The thought of living long enough to leave it left him feeling rather a used up old cad. A feeling he was not partial to.

"You're late," she said, pushing her glasses up atop her head. He thrust a coffee cup at her with a surgeon's precision — quick, sharp and blunt — and sat down across the desk from her in rather a heap. He glanced up at her as he took a sip of his coffee, doing a slight double take.

"Did you . . .sleep in an on-call room last night, Dr. Hughes?"

Her hand, on which her chin was resting, managed to hide the slight smile she allowed herself. After all these years they still referred to one another as "doctor." Other colleagues, in the modern age, called one another by first name. Even the interns did. Maybe they were just too old (or too "old fashioned") but in their way, the respect of the title being flung back and forth between them each day was intimacy.

"No," she said, busying herself with the lid of her coffee cup. She lifted the top off to see that he'd put enough milk in it. He had, of course.

"You lie like a rug," he said, finding her gaze.

"And what if I did, Dr. Carson?" she said, stifling a yawn.

"Don't you think you're a tad bit too old for that?"

She scoffed, sputtering coffee. She reached up and dabbed her chin with her fingers, licking her lips as heat rushed to her face.

"No, I don't." she said, "The day I'm too old to sleep in an on-call room is the day I'll have to retire."

"Dare I ask which of your little darlings kept you here all night?"

She gave him a warning look. For twenty years he'd called her patients her "little darlings" — as if to imply that because she was a woman her motivation for specializing in pediatrics must have been born of some innate maternal desire to nurture. Quite frankly, she'd entered pedes because she already had a wealth of experience by way of her younger sister. Though, she'd never told him any of that. Never told anyone, actually.

She was quite certain there wasn't a soul at Downton — in Yorkshire, for that matter — who knew about Becky. Not that it mattered. Those were matters of the past, and they were best left there. She had more pressing concerns in the present tense.

"4 year old female. Presented two nights ago febrile, fatigue, splenomegaly, anemia. Parents reported she had been complaining of her arms and legs aching but they thought it was a growth spurt. Her white count was . . ." she sighed, having rattled off the essentials with her normal clinical detachment. She knew he'd have already guessed the diagnosis.

"Virtually non-existent?"

She nodded, her eyes downcast. "I haven't told the parents yet. I only confirmed it last night — confirmed thrombocytopenia."

"AML? Or, the other one —?"

"No, you've guessed correctly Dr. Carson." she sighed, "Acute Lymphoblastic Leukemia."

"You'll refer them to an oncologist?"

"Yes, of course." Elsie said, setting her coffee cup down. She turned to the patient's chart, flipping it open. Smoothing the page down with her hand, she scanned for the parent's names.

"She's only just turned four," she said, "Her birthday was in September."

He sipped his coffee, offering her a grunt of acknowledgement.

"Her name is Signey."

"As in Norse mythology? The twin of Sigmund?"

Elsie shrugged, "I don't know, Dr. Carson. They probably just thought it was pretty."

He mumbled, nursing his coffee. After a moment, he checked his watch. "I should probably be off. I've a meeting in fifteen minutes and I'd like to take a walk through the surgical suite."

Without looking up from Signey's chart, Elsie gave him a slight wave.

"Thank you for the coffee, Dr. Carson."

He paused, his hand on the doorknob. "Of course, Dr. Hughes. I'll see you."

As the door clicked shut behind him, she glanced down at the child's photograph, which she had paperclipped to the admissions' forms. Of course they had all the new-fangled technology, but she kept paper records on all her patients. Duplicate effort, perhaps, but she liked having something tangible to keep ahold of as she walked around the pediatric wing. Most important to her was the child's photograph. Taken as a security measure (in case of a Code Pink, or, a missing/abducted child) she couldn't help but think that the photographs aided her diagnosis and treatment somehow. As though even late at night, tucked into her dark office several stairwells away from where her patients cried in their sleep, flipping the chart over and seeing the child's face could inspire an answer, a solution, to their pain.

Other times, though, it only served as a reminder of what might be lost. Some of her patient's charts, tucked away in file cabinets, no longer have a picture with them. In the past, she'd given the photo to the patient's parents when they left the hospital without their little one. Sometimes it was the last photograph ever taken of the child, she knew, and she never laid claim to it even though she could. For legal reasons, maybe. But the charts weren't trophies for her — each one was revered, each one had taught her something. Yes, there were some patients that she had been particularly fond of. Wondered what had become of them. Occasionally she'd get a nice letter or Christmas card from a grateful family. A graduation announcement or two. None of them were her children but in a way, they were all her children. She shook the silliness from her mind, lifting Signey's picture into the light of her desklamp.

She had a mop of red curls and green eyes that once were, no doubt, bright and sparkling but now dulled as cancer ravened her tiny bones. With her sunken face and tightly closed mouth, she almost looked like Becky.

Almost.

* * *

"Which one do you think?"

Cora Crawley looked up from the slice of toast she was buttering to see her husband had appeared in the kitchen's entryway, a tie in each hand and a look of desperate sheepishness on his face.

She licked the butterknife, considering his options a moment.

"The navy one," she said, dropping the knife into the sink. "Your mother hates the purple one."

"Why?" he said, tossing it dutifully on the countertop. She watched him as he began to deftly tie the navy one, not taking his eyes off her.

"She knows I bought it for you."

"Oh, don't be ridiculous." he said, "She probably just thinks that it's a little frivolous for the Dean of Medicine to be parading around with a plum tie."

"Mulberry."

"What?"

"The tie. It's mulberry."

He paused, his tie half undone. She raised her eyebrows, taking another bite of her toast.

"Is that an American thing?"

"What?" she said, her toast crunching loudly.

"Having impetuous names for colors."

She rolled her eyes at him, reaching for a napkin. She nodded toward the handiwork he'd completed with his necktie. "Is _that _a British thing?"

"What?" he said, joining her at the table.

"Crooked neckties."

He looked down, lifting his tie up to inspect it.

"Made you look." she said, popping another corner of toast into her mouth.

"You're worse than a kid." he said, reaching across the table to steal the other half of her toast.

"Excuse me — I was eating that!" she said, gripping his wrist.

"Speaking of children, have you heard from our youngest?" he said, wiggling his arm free from her grasp.

"Give me my toast!" she laughed, swatting his hand. Having secured it, he took a defiant bite, giving her a wolf's grin. She sighed, defeated, and reached for her orange juice. "No, I have not heard from Sybil. But she has midterms this week so I'm hardly surprised. She'll be home in a week for the spring holiday."

"I know," Robert said, pulling the toast slice apart and handing half of it back to her, "I was just wondering if perhaps she'd decided to go on holiday with her friends. You know, tell us that she was staying on campus to work or study or what have you and then go gallivanting off to Spain instead."

Cora blanched, "Why would she do that?"

"Why _wouldn't_ she?" he laughed, "You were young once. Didn't you ever lie to your parents to sneak out to a party? A rave, maybe? You were a city girl, you must have snuck out to at least a few clubs in your day."

"I never snuck out." she said, "I didn't have to. My mother threw enough parties to keep me busy at home."

"Ah yes. How easy it is to forget about your mother when she's not underfoot."

"Robert," Cora said, but she smiled. Yes, her mother was a bit much. But she did miss her. Occasionally anyway. She glanced up at the wall behind Robert's head to check the time, and her eyes widened when she saw how late he was running. "Christ, Robert, it's ten to seven — you're going to miss the Steering Committee meeting!"

She leapt up from the table and ran to fetch his briefcase and a travel mug for his coffee.

"They can hardly start it without me, Cora. I'm the _steer-er_."

She threw him a warning look and shoved his briefcase into his lap. "Don't go in there with your head _quite_ so far up your ass."

"I haven't —"

She hushed him, straightening his tie. "Try to play nice with the others today, okay? Please?"

He sighed at her pout, brushing her hair back from her cheek and giving her a sweet kiss. "And if I'm a bad boy?"

She snorted, petting his cheek. "Then _you_ get to be the one to tell Sybil she has to get her wisdom teeth out over her break from school."

* * *

"I specifically asked for a _male_ donor heart*," Dr. Mary Crawley snapped, shoving the transplant team's cooler back into the tech's hands. Storming out of the OR as she ungloved, she ran smack into Dr. Carson.

"Dr. Crawley," he said, "You look as though you're on a bit of a rampage and it's not even 8 am."

She huffed, pressing her palm against her forehead. "They gave me a fucking female donor heart. I explicitly asked for a male heart."

"Is this your young transplant patient?"

She nodded, "You know what the latest studies have indicated — that male hearts simply have better outcomes. They are associated with longevity and overall better cardiovascular health. I don't _want _a second-rate heart, Dr. Carson. I know they _have _a male heart because I asked them to call me when they did. But that isn't what they've brought me." she turned back toward the OR, where the surgical techs were running around in a frenzy. The anesthesiologist, Dr. John Bates, sat calmly at the head of the operating table, seeming to be perpetually enchanted by the chaos.

"You have a decision to make, Dr. Crawley. Will the patient survive if you wait for the next donor heart — or is this . . ._second-rate heart_, as you say, his last chance?"

Mary pursed her lips. "This heart. . . would be his last chance, yes." she said. She shook her head, having cooled it off a bit. "I'm sure they all think me rather a princess now that I've given them such a show."

"Go scrub back in, show a bit of humility and do what needs to be done, Dr. Crawley." Charles hushed, putting his hand reassuring on Mary's shoulder. She gave him a small smile. Turning away from him and heading back to the scrub suite, he called after her. "Dr. Crawley?"

She turned back, "Yes?"

Charles sighed, "It's been my generally experience that the female heart is not inferior. In fact, it's quite the opposite. Perhaps not on a cellular level, perhaps not in terms of biological compatibility but. . .do not discount the fact that you are being powered by a heart that I know, for a fact, is not in the least second-rate."

She smiled, lowering her head slightly.

"No, go on. Save that boy." Charles said, turning away from her and heading back down the hall. He checked his watch. 6:49 am. He had time enough for another cup of coffee.

Robert Crawley was always late anyhow.

* * *

"Room 23 needs a new bedpan," Joe Molesley said, positioning himself strategically between Beryl Patmore and the exit to the nurse's station.

"Why are you telling me?" she said, pushing him aside. "You know where they're bloody kept."

"We're out."

She whirled around to face him, her badge slapping against her hip. "What do you mean we're _fucking_ out?"

Molesley shrugged. "There's none in the supply cabinet. Not a one."

"Jesus," Beryl said, pressing the heel of her hands against her eyes. "Go on down to infusion and steal a few of theirs, okay? Just enough for the end of your shift. I'll get an order put in."

Molesley nodded and turned on his heels, heading off down the hall. Beryl sighed. When she'd set out to become a nurse she never imagined that the height of her career would include seeing virtually _no _patients, attending stupid meetings at 7 o'clock in the bloody morning and ordering _supplies. _If she'd wanted to do that, she'd have taken a job in materials!

Muttering to herself, she smacked the automated door button and started through it before it had completely opened. She nearly ran into a brightly scrub-clad young woman who shrieked in surprise.

"What the hell are you doing?" Beryl said, grabbing the girl's forearm.

"I'm sorry," the girl said, "You startled me."

"You're in a bloody hospital, not an amusement park, Jesus Mary in Heaven!" she looked at the girl, scanning for her badge. She had one, sure enough — said DAISY, RN.

"I'm the new nurse intern on the unit. My name's Daisy—"

"Oh, good God. Not another one." Beryl said, leaning against the wall. She sighed, giving the automated door button another hard smack. The doors jerked open again and she gestured for Daisy to go in. "Go on — look around for Phyllis Baxter or Anna— she'll get you started. I've got to go to a meeting."

"Yes, Nurse —" Daisy leaned down to look at the woman's badge. She straightened up, smiling enthusiastically. "Nurse _Pat-more,_"

"Oh for the love of God," Beryl groaned, turning away from the girl and headed down the hall. She threw her hand up in dismissal, not turning back as she called out to her from down the hall, "We don't give out gold stars here — _Daisy_!"

The girl wilted, ducking into the unit. She only lifted her head when a tiny blonde woman came around the corner.

"Oh, you must be Daisy!" she smiled, "I'm Anna — one of the nurses here on _pedes."_

"Nice to meet you," Daisy said, looking around. "I haven't even been here for ten minutes and I think I've already managed to piss off the nursing supervisor."

"Patmore?" Anna said, "Don't worry about her — she's tough at first but she'll come around to you."

"I hope so," Daisy said, "I'm so happy to get to do my pediatric rotation here. It's the best unit in England — probably all of Europe. I've read every case study that Dr. Hughes has ever published and I might just die when I meet her."

Anna smiled, "Dr. Hughes is quite the legend — you seem a bit more up on your research than most nursing students we've had. Maybe you've got your sights set on something higher?"

Daisy blushed, "I don't know — I just really like to read."

"Well, I'm afraid you won't have much time for that now." she led Daisy around the corner to the ward. Now that all the patient's had been woken and the breakfast cart was making its rounds — not to mention an influx of patients and family — the ward was bustling.

Daisy's mouth fell open and she felt her heartbeat quicken in her chest as she struggled to take it all in. Her gaze fell on the nurses station where she saw a woman in a long white coat stand up, her hands smoothing her hair as she did. Dr. Elsie Hughes! She glanced up and saw Daisy looking at her and gave her a small smile. Before Daisy could even smile back, an overheard page came through, interrupting her thought.

"Code Blue*, Room 22. Code Blue, Room 22"

Dr. Hughes unwrapped her stethoscope from around her neck and quickly — much more quickly than Daisy would have guessed, knowing how old the famous doctor was — made her way to the patient's room.

"I know I should know for sure but —" Daisy hesitated, "What's a Code Blue?"

Anna sighed, "Cardiac arrest."

* * *

* In fact there has been recent research about male donor hearts being _preferred _by transplant surgeons for this reason. Lady hearts are, apparently, considered quite second-rate on a biological level!

* All hospitals have the right to have various codes — the hospital I am admitted to from time to time uses numerical codes, actually. I had to look up the codes that are considered to be "standardized" but I'll tell you from experience that not _every _hospital uses them as such, so I'll make sure I always mention in the text what the code is for!


	2. Heart in The Right Place

**A/N: **Holy shit you guys — thank you so, so much for all the lovely reviews here and on Tumblr. I am so happy that you're enjoying this and are so psyched for it. Writing and researching it has actually been a shit-ton of fun for me, so I'm pretty excited about it! I've tried to add footnotes at the bottom but if the medical jargon gets to be too much please say so and I'll try to get more creative about exposition in the story so that it can be better explained! :)

* * *

"CPR started," Phyllis Baxter called out as Elsie entered Room 22.

"Molesley, bag him! " Elsie said, coming to the child's bedside. The patient was an eight year old boy. He had been admitted over the weekend with bacterial pneumonia. Not a terribly complicated course, and he was young, so she had every reason to think that he'd be back on his feet without issue.

"Get me a 6.5 mm endotracheal tube*," Elsie said, pushing the bed's guardrails down with a snap. Tube in hand, she positioned herself at the head, intubating the child with practiced ease. Each time she performed the maneuver, she felt a tinge of grief at the realization that she'd done it enough times over the course of her career for it to be practically second nature. Once the child had been intubated, she moved quickly to the other side of the bed to the crash cart. She looked up just as Anna stepped into the room, the new nurse in tow.

"Anna — come here and charge to 2*, please." she said, groping at the contents of the cart for the tube of gel she required to prep the paddles.

"Yes, Dr. Hughes." Anna said, hustling to her side. The younger nurse stood pressed up against the wall, her face colorless.

"Don't stand there," Elsie snapped, the machine whirring to life beside her. She squeezed the gel onto the paddles and rubbed them together, barking orders. "Come take the next round of compressions — Phyllis needs a break."

The girl hesitated, but came bedside just as Elsie called out, "Clear!"

She pressed them against the child's chest and his lifeless body jerked up from the bed. Everyone turned to look at the heart monitor, except for Daisy, who had taken over performing compressions.

"Again," Elsie said, "Clear!"

Daisy lifted her hands from the child's chest and inhaled sharply, watching the monitor.

Nothing.

"Charge to 4," Elsie said, the defibrillator whining under the sound of her voice. She flicked her gaze down to Daisy, "Good technique," she offered breathlessly. Then, before Daisy could take in the compliment, "Clear!"

Again, the child's body writhed on the bed, 4 joules ricocheting around his body, urging him back to life. She passed the paddles to Anna and pointed to Phyllis, "0.01 mg of epinephrine*." She looked down at the boy's body, looking for his IV. "Did you get a line started?"

"He coded before I —"

"Anna, give the defib to Phyllis and come get his line put in." Elsie said. She placed her fingers at the boy's neck, checking for a pulse. Glaring up she caught Phyllis's withering gaze. "You should have started the line."

"I'm sorry —"

"Line's in — 0.01 mg of epi administered." Anna said, stepping away from the bed.

"Charge to 4 again," Elsie said, nodding to Phyllis. Next to her, Daisy had begun to pant, her body heaving over the child's as she pumped his chest.

"Anna, switch out with this one before she faints." Elsie said as Phyllis handed her the paddles. "Clear!"

Then — a blip. Another.

"We've got a rhythm." Molesley said.

"Get a 12-lead ECG on him," Elsie said, passing the paddles back to Phyllis. She pushed past Daisy — but gently — and grabbed the boy's chart from the foot of the bed, wasting no time flipping to his admissions forms. Nothing immediately jumped out as a cause for his arrest — he had no structural deformity that she knew of. No other health problems other than the pneumonia and a penicillin allergy.

Her head snapped up — the antibiotic. She'd prescribed erythromycin* as an alternative to penicillin. "Phyllis, when was his last erythromycin dose?"

"Last night," she said, "I was going to give him this morning's but he coded before I could put his new IV line in."

Elsie nodded, sighing. "Stop the erythromycin. He's got an arrhythmia."

Daisy, having caught her breath, spoke up without thinking. "Erythromycin — that's been linked to sudden cardiac arrest in patients taking CYP3A inhibitors but he couldn't have been—" she stopped when Elsie looked up.

"What's your name?" she said.

"Daisy."

Elsie raised an eyebrow, then looked back at the patient's chart. "Yes, you're right about the CYP3A inhibitors but this patient wasn't on any. He was, however, on a rather high dose of erythromycin and that's enough to cause an arrest from prolonged repolarization. Rare, but possible." She handed the chart to Phyllis and pinched the bridge of her nose with her fingers as she thought a moment.

"Anna, start him on 8 mg of Levofloxacin*."

She stood stoically at the foot of the child's bed, regarding him a moment as the room quieted around her. The steady beat of the heart monitor was reassuring, but only slightly. She turned on her heels to leave the room and found herself running into Daisy, who she hadn't realized had been standing so close to her.

"Is today your first day?" she asked.

Daisy nodded solemnly, though her eyes gave her excitement away. Elsie gave her a small smile.

"Shaping up to be a memorable one, isn't it?"

* * *

"I saved you a seat, Beryl." Charles said, patting the chair next to him in the board room. As per usual, every had arrived except for the Dean of Medicine, who would mosey in at his leisure. As Beryl sat down next to him, she huffed dramatically, teasing him to ask what was wrong.

"I heard they called a code to your unit —" he began, tapping his pen against his notepad. "Excitement abounds?"

Beryl shrugged, "I don't know — called it after I left." she chuckled, shaking her head slightly. "Probably that new nurse into I ran into as I was leaving. Kid's named Daisy. I wasn't sure weather to smack her or give her a sniff."

Charles laughed, "Gave her a good licking did you?"

"She's practically _prepubescent,_ Dr. Carson! I don't need anymore kids on my ward. The patients keep me busy enough."

"Perhaps the Scottish Dragon got ahold of her and she went into afib." he said, reaching for his coffee cup.

He only lovingly referred to Dr. Hughes by the nickname the interns gave her years ago — and never in the presence of anyone except for Beryl. The Scottish doctor's accent was known to thicken when she was barking orders, otherwise it remained at a soothing timbre that comforted the children and their families. If she was cross, however, the fire was far-reaching and not soon forgotten by whomever had caused it.

"She'd give you a swift kick in the arse if she knew you called her that."

He nodded, sipping his coffee. "She slept in an on-call room last night."

Beryl rolled her eyes, "Oh great — she'll be in rare form today, no doubt."

"Isn't she always?"

She was about to toss him a knowing look — she'd known the two of them long enough to know that he'd just assume she _did _give him a kick in the arse — he'd probably had more than a few wet dreams about it over the years. Her snarky reply was intercepted by the sound of the door opening and Dean Crawley* sliding into the room as though he wasn't fifteen minutes late to his own god damned meeting.

"Good morning," he said, "Sorry I'm late — glad you haven't started without me."

"How could we have?" Beryl scoffed, "He keeps last month's minutes under lock and bloody key!"

Robert joined them at the table as everyone murmured their unenthusiastic greetings. He caught Beryl's fleeting look of disapproval and folded his hands atop his folder.

"Patmore, I'm rather disappointed you didn't bring muffins. I count on you, you know."

_Oh, he was a suave fucker, wasn't he_? Beryl thought, her face flushing. He was right, she almost always brought baked goods — either for meetings or for her nurses on the unit. She always made a batch of something when she couldn't sleep — and for the last six months or so, that had been most nights, resulting in a startling number of confections finding their way into Downton Hospital's lounges.

"He could stand to lay off the sweets!"

Everyone looked up to see Violet Crawley in the doorway, her arms brimming with folders and notebooks. She surveyed the room and gave the staff a look of disgust.

"Well, aren't we a sour-faced crowd. If this is the welcome you give your patients it's no wonder our satisfaction scores were down 30 points last quarter!"

* * *

"When you have a moment, Edith?"

Looking up from her paperwork, Dr. Edith Crawley smiled. Her Aunt, Chief of Psychiatry Dr. Rosamund Painswick, waved to her from the door to her office.

"I've a minute now," Edith said, hopping up from the workstation she'd been reviewing charts at. She'd come in early — she almost always did. One of her most recent admissions had gotten rather a rough start and she wanted to be sure that the nurses were following her treatment plan to a T.

As she stepped out of the nurses station, one of her patients — Gerry — turned to her from the coffee machine and gave a shy wave.

"Good morning, Dr. Edith." he said, flashing her a toothless grin. All the patients—and most of the other doctors, actually—called her Dr. Edith as to not confuse her with her sister, Dr. Mary Crawley. Edith hadn't even wanted to take a job at Downton, knowing she'd be mercilessly compared to her sister for all of time if she did. But ultimately the thought of giving up the chance to complete her residency under the tutelage of her Aunt*— who had inspired her to specialize in psychiatry — was worth whatever wrath of Mary's she would confronted by.

Rosamund's office was one of the nicer ones in the entire hospital. It had all polished oak furniture, the walls a deep burgundy and the throw rugs to match. It looked more like an office someone would have at home, bearing no resemblance whatsoever to the unfeeling, bright-white, sterile patient rooms. Even the halls of Downton, with their stark and unnatural lighting and shiny floors felt almost too clinical to be comforting.

"Have a seat," Rosamund said, perching her glasses atop her nose. Edith did, relaxing into the cushy seat — such an improvement over the hard plastic-backed chair she'd been documenting in for the last half hour.

"I wanted to ask you about a patient of yours—" Rosamund said, turning to her computer. "Her name is Margie Drewe."

Edith nodded, suddenly a bit nervous. Was she about to be reprimanded?

"You documented in her chart that you suspect Postpartum Psychosis." she looked at Edith overtop her glasses, "Would you elaborate on that?"

Swallowing hard, Edith pressed herself back against the chair. "Well, she — she presented with classic mania: disinhibition, decreased sleep and during her admission interview I noted loquaciousness. Of course you know she was admitted in the aftermath of violence involving her husband and children."

Rosamund nodded, "Yes, the husband insisted that she be blue-papered* if she wouldn't enter the facility voluntarily. For her safety." she sighed, removing her glasses, "And his, I gather."

Edith nodded, "Well, her youngest child is only six months old. It's well within the timeframe that she could develop a postpartum psychiatric syndrome. Particularly with. . ."

Rosamund waited. "With?"

"The — well, you know. The delusion she has."

"And what delusion would that be?"

Edith furrowed her brow, "I believe I noted it in the chart."

"Yes, you did. But I want you to explain it to me in your own words. Not the documentation required for the hospital to be reimbursed." her face softened, "I want to know what you _think _and what you _feel, _Edith."

"She keeps talking about a child. A little girl — and her husband says that he hasn't got a clue who this child might be. Or who she could be confusing her for."

Rosamund picked up her pen and began to jot down a few notes as Edith spoke, occasionally looking up — trying to keep her eyes for showing too much pride in Edith's thoughtful diagnostics.

"I worry that she may be in the small percentage of women at risk for a relapsing course. Particularly if she has more children." Edith said, "I would like to keep her admitted for the three or four week program and trial her on a course of lithium*"

"You don't think the treatment could be completed at home?" Rosamund said, putting her pen down. "You know it's disruptive for the family for the mother to be hospitalized in these cases — even the moderately severe cases can be adequately treated in the home if the patient is medicated."

"I think it's far more disruptive for them to have her home. Particularly when she gets on about this child."

Rosamund nodded, "That's a valid concern Edith." She turned back to her computer, scanning Mrs. Drewe's chart. "You didn't document much about the delusion — about the child. What's her name?"

"Marigold," Edith said, "She calls her Marigold."

* * *

The operating room was chilly, but Mary insisted it be that way. It kept everyone on their toes —particularly during a surgery as potentially disastrous as a heart transplant. The patient was a teenage boy with cardiomyopathy — likely congenital, but it hadn't become apparent until he took up athletics and began to have fainting spells on the field. He'd deteriorated quickly — his dire need for a transplant even taking her somewhat by surprise. Having reviewed the literature thoroughly, she was insistent that he be in receipt of the next available male heart, which, in her mind would give him the longest possible life. He was only a young boy, probably had yet to even ask a girl out on a date. She didn't want to think that by the time he was 35 he'd be all but dead because she had to trade him one shitty heart for another one.

As she retracted the split breastbone, the sight of his heart beating beneath it made hers beat wildly in her chest. It still thrilled her. She'd seen hundreds of hearts, but somehow the initial view was like seeing it for the first time. Even a weak heart beating was still alive. Still a life in her hands.

"More suction, please." she said, nodding to one of the nameless scrub techs. Mary knew everyone thought she was a bitch for not remembering names, but with everyone suited up in their surgical masks it was nearly impossible to distinguish between the support staff anyway. The one person she did know in the room was the anesthesiologist, Dr. Bates, who had something of a glazed look in his eye while she worked.

"Any decelerations in O2 stats since he went on bypass, Dr. Bates?" Mary asked, taking a scalpel from one of the scrub techs.

"No, he's stable Dr. Crawley. I'd tell you if he wasn't."

Mary shot him a look overtop her mask, "Glad you're paying attention. I thought perhaps your mind may have been fantasizing about that nurse—"

"Dr. Crawley, it's not _my_ heart you ought to be worrying about right now."

Her eyebrow sharply raised, Mary paused. Quite a dose of sass from Dr. Bates. Rather unlike him to be such. Perhaps she'd hit a nerve.

"I'm preparing to excise the left ventricle," she announced to no one in particular, "Is the donor heart prepped?"

"Yes, Dr. Crawley."

"Marvelous." she said, cutting through the tissue with a small flourish. The bypass machine hummed as she lifted the first ventricle out and deposited it into a waiting steel receptacle. As she moved her attention to the right ventricle, she began to grow nervous about the heart she was about to place in the young man's chest. The donor had been a young woman. Healthy, died in a car crash. Still, as she saw the transplant nurse approach her with the new heart — strong and ready to beat — she thought it rather odd that a girl this boy had never met was about to give him her heart.

She only hoped he wouldn't find a way to break it.

* * *

"That meeting was about as useful as a one-armed trapeze artist with an itchy arse," Beryl said — the first one out the door of the board room, as usual. Charles close behind, he merely shook his head.

"I found it useful. I always like to keep my thumb on the pulse of our patient satisfaction scores."

"When was the last time a patient was dissatisfied with your services, Dr. Carson?" Beryl laughed, pausing outside the double doors to the pediatric unit. "If you had one of those little signs outside your office door, it'd probably say "Days since last patient death — _none since Christ was a cowboy." _

Winching slightly, he forced a smile. It was true, he hadn't lost a patient in quite some time — but it wasn't as if those failures were lost to his memory. "Well, perhaps not that long." he offered. She gave him a look and turned, thwacking the automated door button. It shuddered hesitantly, and they realized that from the other side, the button had been struck, rendering the door confused. A huff from the other side, the doors flew open by the force of someone's arms. Elsie came blustering through, seemingly startled to see her two compatriots standing there.

"Oh!" she said, her hand coming to her chest. "Look, the whole motley crew is here." she looked down at their arms — full of notebooks, pamphlets and paperwork. "You've come from the Steering Committee —?"

"Have we ever!" Beryl sighed, pressing her head against the wall. She turned, looking at Elsie sideways, "What was that code earlier, I missed it."

She sighed — Charles noticed then, beneath the hot white light of the hallway, that her cheeks were sallow. She may have been crying not too long ago.

"The pneumonia in 22 — he coded."

"Jesus," Beryl said, "That escalated quickly."

"He's stable for now but. . ." she shook her head dismissively.

"Did you meet the newbie?" Beryl asked, "What's her name — _Petunia_?"

"Daisy," Elsie said gently, "She's one of the smarties, Beryl — don't you dare scare her off."

"Smart one, is she?" Beryl said, crossing her arms. "Well, maybe she learns by _photosynthesis_."

"Go on," Elsie said, wagging her hand in the direction of the unit. Beryl gave her a slight ceremonial bow and made her exit. As the doors clicked shut behind her, Elsie turned to Charles. He looked at her in wait, and when she didn't speak up, he turned to make his way down the hall.

"I was on my way for a refill," he said, jiggling his now empty coffee mug at her. "Are you headed my way? We can walk together."

She smiled, smoothing her hair back from her forehead. "I was just stepping out to collect myself.." she admitted, "I still need to break the news to Signey's parents."

Charles looked down, "Well, like I always say — coffee first, then earth shattering revelations."

She gave him a small grin — their shared morbid sense of humor had gotten them through many a devastating moment at Downton. An acerbic wit came with the territory, she supposed.

He cleared his throat, "My treat, Dr. Hughes. I believe I still owe you for that scone you brought me last weekend."

"You've convinced me," she said, letting her hands flutter in surrender. "You can get me up to speed on what's happening with our patient satisfaction scores."

He gave her a look as they began to make their way down the hall.

"You've never even been to those meetings — how on earth did you know that was our topic of discussion?"

"You do recall that I work on the same unit as "Bitching Beryl."

He laughed, "Does she know you all call her that?"

Elsie laughed, the sound echoing as they rounded the corner. "Dr. Carson, that's what she calls herself!"

* * *

* a child sized tube, they come in various widths based on whether it's for a small throat or an adult-sized one! They even make really, really tiny ones for when you have to intubate an infant!

*kilojoules — when you charge up an AED (the thing you "shock" people's heart rhythm with) you usually start lower and work up, because you want to restart the heart with as little a current as possible.

* epi is adrenaline, basically.

* there is actually a great deal of research about cardiac problems related to this antibiotic — and it's a pretty standard one for people with penicillin allergies.

* Levofloxacin is another alternative to penicillin commonly prescribed.

* No one would call him this, he'd be called Dr. like everyone else — but do you realize how many fucking Dr Crawleys are in this story? Did not think that through.

* In the real world it might not fly that Rosamund would be directly superior to Edith, family and nepotism and conflict of interest and all that. But not entirely unheard of in smaller hospitals. When I was in the hospital last time there was a mother-daughter nurse team that covered the night shift and they worked beautifully together!

* "Blue papering" a patient in the U.S. refers to the blue papers that go in a patient's physical chart if they were admitted against their will by court order. I don't know if the forms are blue in other countries, but it is what they call it !


	3. Old Wounds

**A/N**: Oh, oh, oh! Thank you guys so much for all your lovely reviews here and on tumblr! I'm so happy you're enjoying this fic. Now, I mentioned this on tumblr but in case you're not there — yesterday I was actually in the hospital with a friend, so today I'm completely wiped and this chapter was written in two very different headspaces. So, I make no promises! Again, I've tried to explain some of medical stuff for you in the footnotes at the end. In the interest of full disclosure (since so many of you asked) I am not technically in the medical field anymore: I was a premed student and worked on a clinical trial up until right before the end of this last year. I also have spent time in the hospital as a patient because I have a chronic illness — so, disclaimer is I'm *not* a doctor but I know my way around researching for fic purposes, lol!

* * *

"Damn it," Cora said, squinting at her iPhone. She hadn't quite figured out how to use it. Sybil's picture had come up on the screen and the phone had startled her with an incessant tinkling that she presumed meant she was receiving a call. She swiped her finger madly across the screen and when she heard Sybil's voice, she pressed it to her ear.

"Hi darling," she said, "Can you hear me?"

"Yeah, Mum. I can hear you fine." Sybil laughed, "Still haven't figured out how to use the phone?"

"When you come home next week can you give me smartphone for dumb people 101?"

"That's why I'm calling," Sybil said, "I'm going to leave here Friday night instead of Sunday – so I'll have a few extra days at home."

Cora smiled, "Oh, that's great! I'm so excited to see you."

"Well, I want to see you too. Like, I want to actually see _you_, Mum. I don't want Dad to drag me to the hospital with him."

Resting the phone against the crook of her neck, Cora plunged her hands back into the sink to finish the breakfast dishes. "I think he was hoping you'd shadow Mary for a few days at least."

"Well, I don't want to. So you might as well tell him so before I get there and save the fight."

Cora sighed, "He'll be disappointed."

On the other end of the line, Cora heard Sybil speaking to someone. She must be in her dorm — or maybe she was on her way to her next class.

"Yeah, well he can't always have his way." Sybil snapped.

"He's just trying to support your education, darling."

"Well — Mum, he's _not._ He's trying to support the education he wants me to have, he's supporting his unrealistic expectation of the life he thinks I should have. He hasn't even asked me if I'm enjoying the work. He just wants to know if I'm getting the highest marks."

Cora lifted a glass from the sink and paused, letting the tepid water drip down her hand, "Are you happy, darling? Isn't this what you want?"

She heard someone laugh — not Sybil, her roommate maybe.

"I don't know — Mum, I gotta go. I'm headed to class but I wanted to tell you that I'll see you in a few days."

"Okay. I love you." Cora said, wiping her hands on her jeans. She reached up to grab the phone from where she'd tucked it against her shoulder.

"I love you too Mum."

"Sybil, wait —" Cora said, "How do I turn this thing off?"

* * *

"What happened with your pneumonia patient?" Charles said, handing a steaming cup of coffee to Elsie. She nodded in thanks and they crossed the cafeteria to a corner table — the one they had unofficially laid claim to several decades ago. Taking her seat next to the window, she rested her chin in her hand.

"A fairly uncomplicated bout of bacterial pneumonia — or so I thought. I prescribed erythromycin. I had no reason to think it was contraindicated, he isn't on any other medications and he has a penicillin allergy, so of course that limited my choices a bit. The erythromycin study is fairly recent, an American study. The child was otherwise healthy and has no cardiac history. I felt the antibiotic was a suitable choice but. . ." she trailed off, sighing heavily.

"You're afraid your medical decision making will be brought into question?"

"Of course I am. But, aside from chart audits and patient satisfaction scores, I'm mostly questioning _myself._"

Charles furrowed his brow — a quirk that managed to involve his entire face, given his prodigious eyebrows. "How so?"

She lifted the lid off her cup and blew gently across the surface of the scalding coffee. Hospital coffee was never drinkable temperature — either hot enough to be injurious or so tepid it was unpalatable.

"I suppose I'm worried that I'm losing my touch, Dr. Carson. Perhaps I'm past my prime intellectually and I ought to step back and let the next generation take the reigns."

"I _vehemently _disagree," Charles said, ripping open a sugar packet, "We've all had cases like this." he paused, "It's not really about the antibiotic, is it? It's something else that's got you second-guessing yourself."

She sipped her coffee — burning her tongue. _You deserve it_, she thought.

Setting the cup down, she bit her lip as she looked up at him. He knew her well and while it was more or less a comfort to her, occasionally it was too _close_ for comfort.

"Do you ever . . ." Elsie started, her voice low. "Do you ever regret devoting your life to this career? Have you. . ." she looked up, trying to choose her words carefully, ". . .maybe, you know, wish you'd gotten married and had a family. Worked a nine-to-five."

Replacing the lid on his cup, he lifted it, letting it hover at his lips as he turned the question back to her.

"Do_ you_?"

She sighed, giving him a small laugh. She sipped her coffee — better temperature, but curiously not as tasty as when _he_ prepared it for her. "I don't know," she said, shaking her head. "Maybe. Sometimes."

Charles nodded, "All I think about these days is the prospect of being forced into retirement before I'm damn well ready."

She smiled knowingly, "The only way you'll be leaving Downton is in a body bag, Dr. Carson. Everyone knows that."

"Frankly I won't rest easily unless I know that my body will be a teaching tool for the medical school. Just think, I could remain at Downton for an _entire year _after I'm dead!"

Elsie laughed at this, "Yes, the legendary Dr. Charles Carson: instructing from beyond the grave! Seems fitting to me."

He blushed, "You probably think me ridiculous. Thinking about such things. Trying to plan for a life after death. I often wonder if the residents are losing their respect for me. Perhaps my techniques are antiquated. Any wisdom I have left to give uninteresting or, perhaps, outdated." he sighed, "I wonder if they think me just a sad old man."

Though he said it teasingly, she did see a flicker of pain in his eyes. Perhaps a little regret, a little loneliness. Maybe even fear of the unknown. Her gaze softened. "Dr. Carson, you are invaluable to this hospital. You raise the tone by being a part of it."

His face relaxed into a sweet grin. If she could tell he was touched, so be it. Maybe she should know how much he appreciated that she always seemed to say precisely what he needed to hear —

"Dr. Carson, room 31. Dr. Carson to room 31."

The overhead pager beckoned, and a few moment's later, his beeper buzzed from his pocket. Even though they'd had the little devices for decades, and so too they had to wield an assortment of cell phones and computers, the little beeper still managed to startle him. Elsie hid her smile as she watched him unruffle himself long enough to check it.

"Surgical consult." he said, standing. He hesitated. "Thank you for your kind words, Dr. Hughes."

She stood as well, smoothing a non-existent crease from her white coat. "I meant it, Dr. Carson. And it costs me nothing to say so."

A small look passed between them that made her blush. As she stepped out from around the table, her foot caught on the chair and she stumbled forward. His hand reached out to steady her, landing firmly on her forearm.

He'd never touched her before.

* * *

"Anna, can you look in on room 20 for me?" Phyllis said, her head bobbing up from behind the nurse's workstation as Anna passed.

_Of course she'd say yes_ — and no doubt that was why Phyllis had asked — but she wasn't able to hide the brief downturn of her smile. She'd been headed on break and was hoping to catch John, who would be coming out of surgery any moment.

"Sure," Anna said, turning on her heels back toward the patient's room. _Room 20 _— she thought — _oh yes, the SVT*. _

Stepping into the room, the child's ashen face lit up when she saw the pretty blonde nurse who had, the night before, snuck her in a cup of tea after the kitchen had closed.

"Hi Lucy," Anna said, reaching for the mobile computer unit and pulling it with her toward the child's bedside. She clicked into the girl's chart and scanned for her last vitals and what, if any, note Phyllis had left.

"Anna, my mum's gone downstairs for some breakfast and while she's not here, can you put the telly on MTV for me?"

Anna laughed, lifting her pen from the pocket of her scrubs and giving it a firm click, "Lucy if I didn't know better I'd think you were trying to pull one over on me. Am I to assume your mother would prefer you _not _watch MTV?"

The child gave her a little grin from behind the O2 mask she wore. "Pretty please?"

"I've got to take your vitals first. . ." Anna said, lifting the blood pressure cuff from the side of the cart, "And trust me, you'd rather I get your reading when you aren't dancing your bum off the bed. You wouldn't want your heart monitor to go off — they'd all have to come running in here and give you a shock!"

Lucy laughed, which almost immediately made her gasp. Her eyes widened and her hand shot up, groping for Anna's.

"You're alright, honey." Anna said, smoothing the girl's fringe back, "Try to take a slow breath, okay?"

The child did, and when she'd settled, Anna pet her hand reassuringly. She listened for the child's heart monitor, which thrummed with the quick beats of tachycardia.

Lucy had just been diagnosed with a rather serious heart arrhythmia and had ended up on the ward to try to get it managed. Her bouts of a fast heart rate, however, were frightening.

"Lucy, can I show you a trick?" Anna said, lowering the guardrail of the bed so that she could sit at the foot of it. "When your heart beats very quickly, like it is now, you can do something to help slow it down."

"What?" Lucy mouthed, her voice not quite able to rise over her breath.

"It's called the Valsalva maneuver*. When you feel your heart racing like that, I want you to take in a deep breath like this," she inhaled, exaggerating the rise in her shoulders, "—and then close your mouth and pinch your nose closed." She did, making Lucy giggle — though, it was a cautious laugh. "Now try to breathe!" Anna said, her voice nasal from her pinched nose. Slowly, Lucy brought her hand up and lifted her mask so that she could pinch her nose. Then, mimicking Anna, they strained against their exhalations and within a few seconds, the child's heart began to blip slowly back down to a more calm rhythm.

"Well done," Anna said, resting a hand on the girl's leg.

Daisy, who had paused in the doorway not wanting to interrupt, smiled as she watched Anna with the little girl. She was an excellent nurse, but Daisy was immediately struck by a peculiar sadness in Anna's gaze as she gently replaced the child's oxygen mask.

She wondered why Anna wasn't scrambling to get married and have a few children of her own.

* * *

"Dr. Crawley, may I have a word with you?"

Edith turned, but not because she thought she was being addressed. Instead, her heart thumped wildly in her chest thinking that, for whatever reason, Mary might have found her way down to the ward. The thought of her sister entering her domain — what little she had at Downton — made her stomach clench.

"Oh, Mr. Drewe," she said, "Everyone here calls me Dr. Edith. My sister is a heart surgeon and we are often confused." Mary would beg to differ, insisting that she would _never _be confused for Edith and, likewise, no one could ever mistake Edith for _her_.

"I know you must be terribly busy, but they've taken my wife off for a brain scan of some description. I was hoping we could take the opportunity to talk about her next steps."

Edith offered him an assured smile. Mr. Drewe appeared to be a nice enough man. A good father and husband. Though, if Edith had learned anything by working on the ward it was that people were hardly ever as they seemed — and she didn't necessarily mean that about the _patients._

"Certainly Mr. Drewe. This is a fine time. Have a seat." Edith said, bringing one of the swivel chairs from the nurses station around next to her. With several patients in group and the rest in their rooms, the ward was quiet. It wouldn't last, but she saw no reason not to take advantage of it.

"Margie is seriously ill," Edith began, opening up her laptop. With a few clicks, she opened Margie's chart — then turned back to Mr. Drewe, "I apologize that I must be on the computer while we talk. It feels impersonal to me, but since our records are all electronic now, it can't be helped."

Mr. Drewe smiled, leaning forward as he rest his elbows against his knees.

"I understand," he said, "Amazing what technology can do these days."

"Yes," Edith said, "Speaking of — your wife is having an MRI right now. Before we begin treating her we need to rule out any cause that could be attributed to an undetected stroke or something else physically happening in her brain." She flicked her gaze over to the computer screen, "She had no complications with her last pregnancy? No issue with her blood pressure?*"

Mr. Drewe shook his head, "I don't think so. It was just like the others."

"That's good," Edith said somewhat absently, perusing Margie's delivery note. The obstetrician and OB nurses hadn't noted anything worrisome. Her labs had all be normal, as they had been when she was admitted to the ward.

"Do you know if anyone if her family has depression — or maybe bipolar disorder?"

"I'm really not sure, Dr. Crawley—" he looked up apologetically, "_Edith_. She isn't in touch with them much. And as long as we've been married she really hasn't spoken about them other than to say that her father died when she was very young and — well, her mother remarried and I don't think she got on very well with her stepfather."

"What about her siblings?"

He shrugged, "I'm sorry I'm not more help — she. . .well, she did have a sister who died when they were children. She was hit — they were, um. . .I think they were riding bicycles and she was in the road and — well, she was hit by a construction vehicle of some kind. Of course it was very traumatic for her family but Margie was quite little. Only five or six, so, I don't even know how much she remembers."

"That's very helpful, Mr. Drewe." Edith said quietly, "It certainly isn't out of the realm of possibility that the trauma has been laying dormant, undealt with, for a number of years. Perhaps having children of her own, particularly very _young_ children, has brought it up for her. She may not even be aware of it consciously, but the body remembers."

"I see," Mr. Drewe said, "What will help her? I mean, can she take medication and —" he sighed, rubbing his eyes, "I've got the little ones at home and she's still nursing the baby. I can't do it alone and — if, if she doesn't get better I don't know what I would do. I've got to work and — I've already missed a week with no pay. I'm sure this place is costing us an arm and a leg."

"Mr. Drewe, I think your wife's depression is going to prove very treatable. We can find the right medication regime for her while she's still here in our care and we won't send her home until we're confident that she isn't going to harm herself or anyone in your family. Medication won't solve everything, though. She'll need, I suspect, what we call IOP: intensive outpatient therapy, at least for a few weeks. Then, we can set her up for weekly appointments here, with Dr. Painswick, for cognitive behavioral therapy. That, in addition to the medication, will keep her stable."

"That seems like a lot."

"Well, at first it is — I admit that the transition will be wearing on your family. We will gladly provide you with as many hospital and community resources that are available to you. Now, do you have any siblings yourself, or perhaps a friend who can be of help to _you_?"

"Oh, don't worry about me, I'm pretty tough."

"Mr. Drewe, the supporters must also be supported. Particularly in cases like Margie's." she thought a moment. "Do you know how when you're on an aeroplane and the flight attendants tell you that if the oxygen masks descend, you must put yours on before you put on someone else's? Even your own child's?"

He nodded, wringing his hands.

"You've got to think of it like that. You can't support Margie, can't help her, if you aren't being supported." She put her hand on his knee. He stiffened, and she immediately lifted it — she wasn't even sure why she'd done it, but clearly it had upset him. "I'm sorry —" she said quickly, turning back to the computer screen.

Mr. Drewe stood, brushing his hair back nervously. "Well, she's probably back now, I think I'll — I'll head back down to her room. Thank you for taking a moment to fill me in."

She watched out of the corner of her eye as he walked away from the nurse's station and disappeared around the corner. She sighed, closing her eyes briefly. When she opened them, she looked up to Rosamund's door — where the psychiatrist was standing, arms folded across her chest, her eyebrow raised incredulously at her niece.

* * *

Charles turned the corner into the post-anesthesia care unit (or "PACU*" as the interns were fond of calling it) and rubbed his hand together thoughtfully as he approached the front desk.

"Good morning, Ms. O'Brien." he said. He looked at the clock behind her — it was nearly noon. "Well, rather, good afternoon I guess."

"Dr. Crawley needs you for a post-op consult in recovery 2 —" she said without looking up from the computer. Ms. O'Brien was rather new to the unit and a bit of a mystery. She didn't seem to have made any friendly relations with anyone and she almost always looked as though she'd rather be somewhere else. Oddly, no one could complain about her _exactly_, because other than being a bit of an odd duck she was an excellent administrative assistant and the PACU nurse's station had never been so organized.

He nodded, giving the top of the desk a rhythmic task to send himself off down the hall. The heart monitor's blipping around him, the squeak of a gurney as someone was being wheeled in or out of the OR: all of it music to his ears.

He rapped lightly on the door to the patient's room, then pushed it open. Mary was at the patient's bedside, leaning over the nurse anesthetist*. She looked up when she heard him pad across the floor.

"Thank you for coming so quickly," she said, her face a bit drawn. "I don't want to appear alarmist, but I think the patient may be rejecting the heart."

Charles balked, "Dr. Crawley, the patient has only just left the operating theater—"

"I know, Dr. Carson—"

"If you thought he was in hyperacute rejection of the cardiac allograft* you shouldn't have closed."

"I _know, _but—"

"No, Dr. Crawley, I'm not convinced that you _do _know." Charles said, unwinding his stethoscope from round his neck and moving quickly to the patient's bedside. The nurse handed him the chart, her expression somber. Over the years Charles had learned that it was often nurses — _not doctors _— who were the best ally to patients. Unlike many doctors who tended to look down on their nursing staff, he had always maintained the utmost respect for them professionally and he had found that this amicable relationship had been as useful medically as it had been socially.

"You started him in antihypertensives and immunosuppressants*?" Charles said, biting down on his pen as he reached up to look at the fluids being pumped into the patient.

"Of course," Mary said, joining him at the bedside. "There was nothing in his history or lab work to indicate he would reject."

"Did you test for anti-graft antibodies?" he said, typing furtively into the bedside computer so he could access the patient's lab findings.

"Dr. Carson, you ask as though you are suspecting I did not."

"_Did you test for anti-graft antibodies_, Dr. Crawley?" Dr. Carson snapped, turning the screen toward her, "Because unless my eyes deceive me, I do not see those labs resulted. As a matter of fact, I don't even see an order."

Mary blanched, her jaw falling open. "Dr. Carson, I placed that order."

"Are you certain?" he said, his fingers clacking against the keyboard loudly. She felt her bottom lip tremble as she realized that his mouth was in a tight, thin line — so rarely had he been angry or even dismissive of her. Not only had she disappointed him but she damn well might lose her patient.

"All the other pre-operative lab orders were placed."

Charles sighed, "Do you remember what it said?"

"The labs?"

"The anti-graft results, Dr. Crawley." he sneered, "_Do you remember _what the results were?_ Do you remember_ seeing it?"

"I reviewed all the labs—"

"Dr. Crawley, I do not see the labs. I do not see an order for these labs. So, in my book, that means they were not done. The proof is in the pudding — or, in the case of your patient, the proof is faultily beating away in his chest as we speak." Fuming, he walked around the other side of the patient's bed, almost as though he couldn't stand to be near to her, and spoke quickly to the nurse. "See that extracorporeal photophersis* is initiated immediately and that those labs are redrawn. I'll call up to the lab and tell them it's urgent."

He turned back to Mary, but refused to look her in the eye. "Dr. Crawley, you are off this case."

Mary scoffed, "Dr. Carson–"

"Page _the other _Dr. Crawley, please." he said to the nurse, "He will continue on and see the patient through the photophresis."

He moved briskly past Mary as he exited the room. When the door had shut behind him, the nurse looked up from where she was charting.

"I've been here fifteen years and I've never seen him that angry." she said, shaking her head lightly.

"Shut your bloody mouth or I'll see to it that you don't make it to sixteen!" Mary spat, turning on her heels and managing to exit the patient's room just as hot tears began to burn her eyes.

* * *

* SVT = Superventricular Tachycardia is a type of heart arrhythmia where the electrical impulses that govern your heartbeats are abnormal, and they kind of "rapid fire", making the heart "race" (tachycardia). It's a lot more complex than that structurally, but I just kind of bastardized it.

* The Valsalva Maneuver is often quite helpful for children with SVT once they are old enough to understand how to do it properly and recognize when their heart is racing. It can often help in the day-to-day struggle of SVT, but in severe cases hospital trips may be required to get it controlled.

* One of the first things they would be looking for, actually, would be if she had what Sybil died of in Downton Abbey: preeclampsia. When a pregnant woman's blood pressure rising dangerously during/directly after her pregnancy there can be fatal complications, such as a stroke (more or less how Sybil died). That's why Edith's asking — furthermore, Margie is having an MRI to rule out any structural abnormality (like a tumor) that could be causing her symptoms. Once they've ruled anything physical out, they'll start her on medications to treat depression and, perhaps, bipolarism.

* In the hospital where I was working on the trial they called it the PACU, I'm sure other hospitals have other names but for the purpose of this fic I'm just going with what I'm used to, haha!

* Nurse Anesthetists are board certified RN's who can, and often do, perform anesthesia procedures either with an anesthesiologist or under the guidance of one. The hospital where I used to work only had 1-2, but they were really cool and I wish I'd learned more about their job. Granted, they may be slightly different in UK hospitals, but for the purpose of this AU I would like there to be people performing this very cool nursing job because maybe it'll inspire a reader to join the profession as well, which would thrill me!

* Hyperacute rejection is, of course, very rare. Prior to the heart transplant the tissue of the donor heart is tested against that of the patient's to make sure that there won't be any immediate issues. Remember that we all have our own antibodies, and not all of our antibodies would play nicely with someone else's if we mixed them all together. Someone getting an organ transplant gets a big dose of immunosuppressant drugs that help make sure their antibodies don't reject foreign tissue until it learns it doesn't have to defend the body against this new organ. Rejection isn't totally uncommon, though, but it usually happens weeks or months after the transplant, not within the immediate post-op period. It does happen, though.

* Photophresis is SO COOL. Basically it's a measure to help the body _not _reject the transplant. The easy version is this: the patient's blood is pumped out of the body an exposed to UV light — think of it as being "cleaned up"— and then it gets pumped back into the body, the hope being that it has cleared out the lymphocytes from the donor tissue. It's part of a treatment protocol called "photoimmune therapy" and it's pretty fucking awesome. I love modern medicine!


	4. Open Wounds

**A/N: **Hello my loves! Thank you, thank you for all your messages, reviews, replies and tumblr chats! They give me life! :D So, this is a shorter chapter. . .and you'll be seeing the first of a few new patients, one canon and one from our amazing fandom! There are 20+ of you to make charts for now and I'm totally pumped. This is turning into such an amazing project! Angst ahoy, but don't worry — remember, every relationship has its ups and downs! ;)

* * *

"Dr. Hughes, you've got a new admit in Room 19. She's come from the ER." Beryl said as Elsie strode past the nurse's station. Elsie paused, taking a few steps backward to reach for the admissions form's Beryl had slid over top the counter.

"Is she critical? I've got to speak to Signey's parents urgently."

"Good luck with that—" Beryl said. "She's being transferred to Saint Mary's."

Elsie head snapped up, "That's impossible, I haven't authorized her transfer."

"Yes, you damn well did." Beryl said, tapping her computer screen, "Says right here. Didn't you just dictate this discharge note?"

Elsie came round to Beryl's side of the desk and hovered at her shoulder, "I most certainly did not," she huffed, "Ask Dr. Carson, I've been with him for the last quarter hour."

Beryl smiled, "Any witnesses seen you two or were you tucked away in an on-call room?"

"Oh, for Christ's sake!" Elsie snapped, sitting down in the chair next to her and picking up the phone. She dialed, giving Beryl a look. "I did _not _authorize that transfer—yes, hello this is Dr. Hughes in pediatrics. There is a patient — Signey Saint James — yes. Well, no — I did not authorize her transfer. No, I did not. I don't know who did, but they've done so in my name either by mistake or —" she listened, her mouth gone slack. Heat rose to her face and Beryl knew that if ever there was an occasion for the Scottish Dragon to rear her head —

"The child has left this hospital against medical advice, under false pretenses and potentially fatal misguidance. She needs to be returned to my unit at once." a pause, "Please connect me to your supervisor." Another beat, her eyes widening, "Well — then you ought to know better!" she stood, the phone's cord snaking around her arm, aggravating her further, "If that child perishes en route I will see that you are held personally responsible, _Mr. Lawrence. _I would advise you to acquire a _very _capable attorney."

She slammed the phone down and turned to Beryl, "Call down to the records office, have them run an audit on my access for the last three hours. Someone dictated and signed off on that discharge and transfer and it wasn't me."

"Are you sure you didn't just dictate on the wrong patient? Was there anyone else to be transferred today — maybe you just made a mistake."

"I did not make a _bloody mistake, _Beryl." Elsie roared, the other nurse's on the floor lifting their heads to look up. Her face flushed, Elsie turned and pushed her way through the unit, her heels clicking hard against the floor. As she made her way out of the unit and into the main hallway, she realized she wasn't even sure where she was going. She had other patients who needed to be tended to. There was an ever-growing pile of documentation and charting to be done in her office. She paused, having reached the atrium, and hesitated a moment. To her left was the hallway leading down to the surgical wing. She wasn't sure which of her competing emotions (anger, fear, grief) fueled her, but once she took a step toward his office, she fully surrendered to whatever was carrying her there.

She rapped on his door with the back of her knuckles. "Dr. Carson, may I have a word?" she said.

"One moment," he said — but in her haste she opened the door and pushed her way in regardless. He was sitting behind his desk, face lifted from his hands, red and sallow. Had he just been crying?

"Dr. Carson," she said breathlessly, "I'm terribly sorry. Forgive me."

"What is it, Dr. Hughes?" he said curtly, knowing he'd been caught out. "I'm in the midst of a critical case gone wrong and I haven't got an iota of time to devote to your _little darlings_."

She pursed her lips, "There's no need to be rude, Dr. Carson. I'm not here on a bloody_ social call._" she took a few determined steps toward him, "Someone has transferred a patient under my name. The leukemia patient I told you this morning has gone to Saint Mary's — I did not authorize the transfer, but the note has been dictated and signed off on."

"Saint Mary's has a world-class pediatric oncologist*—"

"That is hardly the point, Dr. Carson. Someone has dictated a discharge note and authorized a transfer under my name and now a patient has gone off against my medical judgment, and God only knows what, if anything, her parents were told about her condition."

"Are you positive that you didn't dictate under the wrong patient? Perhaps in the chaos of your unit this morning you dictated the note and just don't recall —"

"Yes I'm bloody positive, when would I have had time? I spent half the morning with you!" she sneered, "Do you recall me dictating any notes?"

"Dr. Hughes," he said standing, his hands slapping down hard against his desk as he leaned forward, "If your work is suffering —"

"Dr. Carson!" she snapped, whaling her hand down hard against his desk, looking at him straight on, "You are the Chief of Staff at this hospital and I need you to find and terminate whomever has used my name, my _license _to make an unauthorized transfer. I am not here for a performance evaluation, I'm requesting that you do your job!"

"I am _trying_ to do my job!" he bellowed, his eyes heavy and pained. She pulled back from him, realizing a bit too late that she'd hit a nerve. He lifted his hands from the desk and pressed his fingers against his temples, lowering himself back down. "The records department will need to run an access audit. Place the request and if they haven't completed it by this afternoon, let me know and I will expedite it."

She nodded, her face hot and buzzing, her hands having gone a bit tingly from their screaming match. "I have."

"Good," Charles said without looking up from his desk, "Please hand write your notes for the rest of the day. If anything else crops up in the electronic record we'll know for sure it hasn't come from you."

"Yes, Dr. Carson." she said quietly, turning to leave.

"Dr. Hughes?" he said. She paused, turning back to him.

"Yes?"

He sighed, his shoulders shaking, "I know you're in the midst of something but I would like your medical opinion on something. Can you spare five minutes of your time?"

She softened, nodding as she took a few steps toward his desk and gingerly sat down in the chair across from him. She folded her hands in her lap, tilted to head to one side — and listened.

Dr. Matthew Crawley wiped his palms against his crisp white coat for the third time in so many minutes as he made his way through the maze of Downton Hospital's halls. He'd started his residency* here a few weeks ago and was still struggling to get his footing. His mother, Isobel, had insisted that he take them up on their offer — even though he would have been thrilled to have been matched* anywhere else — _anywhere _but the hospital his mother worked for.

_Anywhere_ but Downton.

Just as he rounded the corner to the PACU, he paused. He'd been paged and no doubt for something more interesting than the stress test* he'd been overseeing. Still, the thought of running into _the other Dr. Crawley, _made his stomach lurch. Mary Crawley, MD, was legendary. Even though they weren't that many years apart in age, Mary had started her medical training early and, thus, completed her residency before Matthew had even begun his. She was now an attending in cardiothoracic surgery. He'd certainly been aware of her chosen specialty when he'd begun to think about his, but having landed at Downton (which was widely accepted as _her _turf) he hardly wanted to launch himself into a competition with her. Still, to try to suppress _his _passion for the speciality would only hurt his patients. He couldn't be bothered to worry about hurting her feelings. If she had any, that is. Not that he'd had that many interactions with her as of yet, but _the _Dr. Crawley's reputation preceded her.

He stepped into the ward and was met by a flourish of young nurses. _"Hello, Dr. Crawley, so nice to have you on the unit, you look well," _all the while stealing glances at his left hand in search of a wedding band. He cleared his throat, sidestepping their attentions as he made his way to the patient's room. Behind him, he heard one of them murmur, "_Now I know why they call him Dr. Crawl-into-my-bed."_

The atmosphere of the patient's room was grave, a far cry from the air of delight that had just welcomed him at the nurse's station. The only sound to welcome him into the darkened room was the uncertain blip of a heart monitor and the wheeze of a ventilator. He positioned himself before the mobile computer unit and entered the patient's chart:

_Patient: William Mason_

_History of Present Illness_

_The patient is a 17 year old white male with a history of cardiomyopathy. Management with pharmacology and biventricular pacemaker and LVAD have not been successful. The patient's cardiomyopathy progressed rapidly and there may be a heritable component to its severity. Patient's mother died when he was a child of hypertrophic cardiomyopathy. Strong suggestion of familial hypertrophic cardiomyopathy* in this patient. Further testing indicated and patient will be placed on the transplant list pending availability of suitable donor heart._

—_Mary Crawley, MD_

He flicked his gaze over to the young man in the bed. He may have only been seventeen but he looked somehow older. Trauma did that to you, Matthew supposed, pushing the computer away as he went to the William's bedside.

"Dr. Crawley, I see you've found your way here in a timely fashion."

Matthew turned toward the door at Dr. Carson's voice. He was surprised, however, to see Dr. Hughes in tow.

"I don't believe we've met," she said, sticking her hand out, "I'm Dr. Hughes."

Matthew stood, wiping his still sweating palms before shaking her hand earnestly. "I know — the pleasure is mine, Dr. Hughes. I just read your study on obstructive lung disease in children with idiopathic scoliosis.*"

Elsie raised an eyebrow, "Oh? Well, lovely to hear that someone did."

"Admittedly I read most of your research prior to arriving."

"Had you considered a pediatric residency, Dr. Crawley?"

"Considered yes, but was not matched I'm afraid."

Elsie nodded, "Well, that oversight is a conversation for another time—and hold me to it. But let's have a look at our current patient. I hope you don't mind that Dr. Carson has asked me to consult on this case, given the patient's age."

"Of course," Matthew said, "I was just reading Dr. Crawley's — well, the other, the first— Dr. Crawley?" he stuttered a bit, "I think perhaps this will become confusing rather quickly. Perhaps I ought to see about a name change."

"Mary Crawley is no longer on this case," Charles said sharply, "There will be no confusion."

Matthew blinked, but inquired no further. "Good, then. I suppose." he looked up at Elsie nervously and her eyes softened, calming him wordlessly.

"Dr. Crawley what is your initial impression?" she said.

Matthew sighed, looking down at the boy. "He's having a shit time..." he said under his breath. He only realized Dr. Hughes had heard him when he flicked his gaze up at her and saw her trying to hide a half-smile.

She cleared her throat, "Your _medical _opinion, Dr. Crawley?"

"Hey, Tommy! Stop sexting and get your ass in gear. We've got a call."

Tom Branson looked up from his phone — "Am I driving?"

"You can attend this run."

Tom nodded, grabbing his bag and slinging it over his shoulder. He pocketed his phone and followed his crew member to the ambulance bay. "What've we got?"

"8 year old female, name's Chelsie. Impaled by her bicycle."

Tom looked up, "Christ—_what_?"

"Yep. Hit a rock and instead of letting go she held on to the handlebars, landed on top of the bike and the kickstand went right through her."

"Holy shit." Tom said, climbing into the back of the ambulance. His phone buzzed and he glanced down.

_SYBIL (2:21 pm): Hey! :) I'll be home this weekend wanna grab a drink? I'm trying to avoid the hospital if I can manage it but let me know what night you're not on call and maybe we can go out or something. :P_

As the ambulance sped off, Tom attempted to shoot off a quick text in reply, but the jostling made it particularly trying.

_Tom: (2:25pm) Hey on a run right now forgive typos kid impaled by her bike wtf would luv to see you let me know when you get home :)_

"Grab a couple Ringer's*, kid's probably gonna be in shock."

Tom exhaled deeply, stuffing his phone in his pocket, _"I'm _probably gonna be in shock."

* * *

* I'm not sure if they are world-class, but Saint Mary's appears to have an enormous pediatrics department.

* I've explained the idea of a residency (and Matthew's in particular) over on my Tumblr ( post/111777214200/downton-hospital-medical-jargon-uk-us)

* "Matching" is the term used by med schools in the US when a new doc finds out which hospitals have accepted them as residents. Match Day is like a super nerve wracking/exciting day.

* A diagnostic that is done to assess how your heart functions during different levels of activity. You know when you see a patient in a movie or TV show on a treadmill which a bunch of stuff hooked up to them? That's a cardiac stress test.

* Honestly, I was thinking about how in canon William's mom died of some heart condition and it made me think that this particular condition could be an interesting way to bring him into the story. Mostly because I rather liked William and I miss him but also because writing about a heart transplant was high up on my to-do list.

* A real study I just read( article/S0022-3476%2814%2901239-6/abstract), but alas Elsie Hughes didn't author it!

* Ringer's = Ringer's lactate — they give this to you in an IV when you need fluids. If you've ever been in the hospital or had surgery and had an IV an you get "fluids" you're probably getting Ringer's.


	5. Golden Hour

**A/N: **Hello, hello again! Thank you all so much for the love and reviews — you guys are amazing and your enthusiasm continues to give this fic life, so I sincerely thank you! This was a really hard chapter — required a lot of research and I'm sure I screwed up somewhere or missed something pivotal, so don't take any of it as medical gospel. I'm making a _Grand Rounds _post on Tumblr to expound the many, many challenges in treating pedes patients versus adults — there are a lot of crucial differences to consider, especially in a trauma. Also, if you have a moment, head over to my tumblr ( .com) and check out the amazing banner that silhouettedswallow made for me! SO LOVELY. As always, a few medical jargon footnotes at the end of the chapter, but let me know if there's anything else you want to know about in more detail! Also thanks to chelsie-carson for sharing her story — lucky for all of us she survived her bike-kickstand impalement!

* * *

"8 year old female, impalement — bolus of normal saline en route, hypovolemic, diminished lung sounds —probably tension pneumothorax*." Branson said, leaping out of the back of the ambulance.

"What's her name?" one of the emergency room nurses said as the rest of the trauma team closed in. Pushing the gurney into trauma bay one, Branson doubled his steps to keep up.

"Chelsie," he said, "She was alert when we got there but went into shock en route."

"Call up to pedes, page Dr. Hughes." a nurse said as she hung up a saline bag. One of the ER doctors came in, took one look at the scene and started barking orders as he gloved up.

"Page Dr. Carson and get the portable chest x-ray —"

* * *

"_Dr. Carson, ER trauma one. Dr. Carson to ER trauma one STAT._"

Charles looked apologetically at Matthew, "You're set to continue on here?"

Matthew nodded, "Yes — thank you Dr. Carson." he turned to Elsie, "And to you, Dr. Hughes. Your input has been invaluable."

"_Dr. Hughes, ER trauma one. Dr. Hughes to ER trauma one STAT._"

Elsie furrowed her brow, turning to Charles. "Oh dear, must be serious if they've called us both for a consult." she turned back to Matthew, "Page us back if he arrests again."

Matthew nodded watching as the doctors left him, finding himself alone once again with only the bleeping of a heart monitor and the thump of his own heart swelling in his ears.

"What have you brought me today, Mr. Branson?" Charles said, striding down the hallway of the emergency room trauma bays.

"Penetration injury to the chest, kid landed on her bike kickstand. Hypovolemic, bolus of two units normal saline en route but her BP is elevated and she's decompensating. Pericardial tamponade, decreased breath sounds and hyperresonance — thinking possible tension pneumothorax."

"Chest x-ray?" he said, joining the trauma room fray. The ER physician looked up at him only briefly, then returned to staunching the wound's bleeding.

"Enlarged cardiac shadow, widened upper mediastinum." the doctor said, packing more gauze against the child's side.

"Diaphragmatic injury?" Charles said, squinting at one of the x-rays.

"Can't be sure, no visible rib fractures — that's why we paged you. She's going to need a laparotomy."

"Is she hemodynamically stable?" Elsie said, coming to the side of the gurney.

"Getting there—" one of the nurses said, handing more gauze packing to the ER doctor, who reached up to wipe his brow on the back of his hand.

"What's her name?" Elsie said, leaning over the child and taking her pen light out of the front pocket of her white coat.

"Chelsie," one of the nurses said, "She's 8."

Shining her light into the child's eyes, the lull of her voice carried over the chaos of the trauma bay as the team worked around her. She paused, taking the child's hand and squeezing it. "Chelsie, darling, can you hear me? You're in the hospital. You've had a bit of an accident but you're going to be okay." She glanced down at the child's hand, which was pale and limp against hers.

She looked up, finding Charles' gaze just as he made his way to the gurney opposite her, "Perfusion is poor—give her another bolus of crystalloid."

"Call up to the OR, tell them we're bringing up an emergency exploratory thoracic lap, possible diaphragmatic rupture. Dr. Hughes, we need to perform pericardiocentesis* preoperatively to relieve the cardiac tamponade."

"Do we have an ultrasound?" she said, whirling around to the nurse, "I can't go in blind."

"You don't have time—" one of the nurses said, handing her a syringe.

"1% lidocaine, please" she said, turning back to the gurney, "and this is the wrong syringe — get me a 60 ml."

"Yes, Dr. Hughes."

"Go through the left sternal costal margin," Charles said as he finished placing a nasogastric tube.

"I've performed emergency pericardiocentesis before, Dr. Carson. Probably more of them than you." she said, taking the scalpel from the tray of tools the nurse had set next to her. She made a small incision into the child's side. "Aspirating 5 ml of normal saline," she said, taking the syringe and injecting it into the incision.

"You're too close to her heart," Charles said, "Her ECG—"

Elsie pulled the needle back gently, "Dr. Carson —"

"Her ST waves are elevated!"

"Dr. Carson, _please._" Elsie hissed. She flicked her eyes quickly up at the attending ER physician, "Get the catheter placed and transport her to the OR, her diaphragm may have ruptured."

Lifting the now full syringe, she passed it to the waiting nurse and looked up at the child's face. Her color had begun to return and she blinked, her eyes focusing.

"She's stabilizing," one of the nurses said, "BP's normalizing."

Elsie reached up and smoothed the girl's bangs from her clammy forehead, "Darling, my name is Dr. Hughes. You're at Downton Hospital. You've had an accident but we're going to fix you up."

The girl opened her mouth, her breath rasping as she realized she couldn't speak.

"There's a tube in your throat to help you breath, don't try to talk." she looked up and toward the hallway, "Where are her parents?"

"I'll get them," one of the nurses said, stripping off her gloves and pushing the curtain back.

"Jesus," Charles said, looking up from the injury, "Did you say this was from a bike kickstand?"

"That's what the parents said," the ER doctor said.

"Why, how bad is it?" Elsie said quietly, her thumb caressing the child's forehead.

Charles looked up at her, his eyes stony. "Ask the attending to interview them. And place a call to social services."

"Dr. Carson?" she said, her breath hitching.

"She's stable — let's move!" one of the nurses said, kicking down the lock on the gurney. As she began to move, the girl looked up at Elsie, terror shining her in eyes. With a purely primal surge of strength, she reached up and grasped Elsie's forearm in a death grip.

"I won't leave you," she said, her steps quickening as the gurney picked up speed, racing to the elevator. She looked up at Dr. Carson and he nodded.

She'd scrub in.

* * *

Robert picked up his cell phone on the third ring — he knew it was Cora, and for a moment he'd considered letting it go to voicemail. The afternoon had taken a turn for the worse and he hardly had the patience for any domestic complaints that she might have for him. Still, hearing her voice usually managed to put him in better spirits. Even if she was only calling to remind him they needed dishwasher pods.

"Hi, dearest." he said rubbing his eyes, as though she would hear the fatigue and agitation in his voice. "How's your day been?"

"Sybil phoned – she's going to be home on Friday." Cora said, but her voice was hesitant.

"Yes, and—?"

"Well, she doesn't want to shadow at the hospital. She just wants to have a holiday. You know, a real holiday. Lazing around in her PJ's and all that."

Robert sat forward, pressing his elbows against his desk, "Cora, she's a med student, she needs to use all her time wisely. No _lazing about_."

"She's exhausted, Robert." Cora said, "I don't see how a week and a half of rest could possibly hurt her efforts."

"She might as well not come home at all if she doesn't want to accomplish anything," Robert said curtly, "If she's not serious about her medical training than she might as well have taken off to Spain."

"Is that all that matters to you?" Cora spat, "That she come home and work? Don't you want to see her?"

"Well _of course_ I want to see her, but she's only coming home to sit on her arse for a week and forget everything she's worked on this semester—"

"Robert, she's your daughter not your intern!"

"Did you only call to upset me Cora? Because I really don't need it. I've got a major administrative crisis and—"

"There's_ always _a crisis, Robert." she said, her voice low. "Don't forget to pick up dishwasher pods on your way home."

The click as she hung up echoed in his ears for a moment before he lowered his phone to his desk. He gave himself only a moment before he shook his head and turned back to his computer. At the top of his unread emails was a response from the records department.

**SUBJECT: HUGHES MD ACCESS AUDIT**

* * *

In the hospital chapel, the only quiet reprieve in a building that was brightly lit and either painfully loud or unnervingly quiet regardless of the hour, Mary sat alone in the pew farthest from the door. She hadn't come to pray, though she was asking forgiveness. Not from any higher power though. Not from Dr. Carson. Not even her patient.

It would have been disingenuous for her to fail to admit, even to herself, that the few tears she allowed herself to shed, wiping them on the back of her shaking hand, were for the one person she continuously let down no matter how hard she tried: _herself._

* * *

"I'm sorry I couldn't steal a moment earlier," Anna said, letting her head rest against John's shoulder as he embraced her. She hummed contentedly, "I'm so glad to see you."

He smiled, his lips against her ear, "I think we've been found out."

Anna pulled back, her eyes wide. "John–?"

He laughed, "I was in surgery with Dr. Crawley this morning — I told her she ought to worry about the patient's heart, not mine."

"You didn't. . ." Anna gasped.

"I did."

"What did she say to that?"

"Not a whole hell of a lot," John said, kissing her gently, "Which I considered a victory."

"How did the surgery go?"

"When I left the post-op suite she'd been booted off the case. Guess he's rejecting the heart and decompensating. I think they brought in the _other _Dr. Crawley?"

"Edith?" Anna said, "She's a psychologist—"

"No—the _non-Crawley _Crawley. The Anti-Crawley."

"Ohhh," Anna said, giving him a knowing grin. "Matthew."

"It's his one shot to prove himself, you know? Hope he doesn't bugger it."

"John," Anna chided, slapping his chest lightly. "We shouldn't speak ill of someone we barely know."

He smiled, kissing her neck. "Yes, you're right — let's leave our gossip for the twats we _do _know."

She squealed as he tickled her ribs, "John—stop it!" she laughed, "We're going to really get caught —"

The buzz of his beeper in his scrubs' pocket interrupted their play. "Fucking _fuck!" _John cursed, pushing back from her. He squinted at his pager and his eyebrows shot up — "_Ooph_, pedes trauma. Carson's taking them in and he's requested me specifically." he looked up at Anna, a hesitant grin of pride tugging at his lips.

"Oh, go on then—" she pouted, "Enjoy your moment. I really ought to head back. I've got to show our new nurse intern about charting."

"How's her first day going?" John said, slipping back into his white coat.

She wrapped her arms around him once more, pressing her face against his chest.

"Beryl's only yelled at her once and I think Dr. Hughes has taken to her already."

John chuckled, kissing her hair. "Intern or not, sounds like she's having the best day out of all of us."

* * *

"Dr. Bates, administer a peripheral nerve block* if you would please." Dr. Carson said, backing into the OR, his sterile hands lifted up in front of his face. Met by one of the scrub nurses, who donned him a gown and sterile gloves, he looked over his mask at Elsie, who had already scrubbed in and was at the head of the operating table monitoring the child's vitals.

"How'd she manage this?" John said, reaching for a syringe. "Looks like a pretty serious stab wound."

"Overturned bicycle, landed on the kickstand." Elsie said, her surgical mask muffling her speech a bit. "Though Dr. Carson has his doubts about the legitimacy of that account."

From behind his surgical mass, John's eyebrows flared, "Shit." he turned his attention back to the needle, "At least she won't feel anything now."

"I suspect she has a diaphragmatic injury — we'll repair and relocate any of the abdominal organs if there's been herniation." Charles said, joining them at the operating table. "Dr. Hughes, I'll begin with a left lateral thoracotomy*. If you would standby to assist with maintaining visibility." He looked up to the scrub nurse, "#10 blade scalpel please."

Charles made the initial incision, a thin line running the side-length of the child's tiny chest. "Cautery, please."

Accepting the cautery tool from the scrub nurse, Elsie wielded it into the bleeding incision, the distinct smell of burnt flesh* filling the room even with her surgical mask.

"Gigli saw*, please," Charles said, his eyes dark and focused. Elsie took a deep breath, lettering her own eyes flutter closed. The whirring of metal against bone sent a shiver up the back of her neck. It was an unsettling noise in and of itself, but within the delicate fascia of a child it was even more disquieting. Even though she knew the girl was entirely unconscious and unaware of what was transpiring around her, she reached down and gently took her hand just the same.

"Bone wax, please." Charles said, handing the tool back to the scrub nurse. His shoulders shook as he rubbed the edge of the sternum with the wax, preventing any bleeding from the marrow. He held his gloved hand out, palm up, to receive the cautery tool.

"When was the last time you scrubbed in on one of these, Dr. Hughes?" he said without looking up from his work. Elsie lifted her hand from the child's and opened it to receive the tool from him as he finished cauterizing.

"It's been a long time, I admit. There are some sights and smells you don't soon forget, however."

"'tis a precious few who can say they've experienced the smell of a burning bone dust." he turned to the scrub nurse, "sternal retractor please." turning back to Elsie, he gave her a heavy glance from behind his mask. "I'll need to to apply traction to the sternal edges."

She nodded, dipping a gloved hand into the child's exposed sternum. As she did, Charles firmly placed the retractor, exposing the delicate web of viscera beneath. He set to work clipping and cauterizing the vessels of the thoracic cavity until at last, the child's organs came into view.

"Suction please," he said, narrowing his gaze a bit. He sighed again, looking up for Elsie's gaze, "Abdominal organs are herniating into the cavity, but I can already visualize a tear running into the upper diaphragmatic lobe. We need to replace the organs and then I'll repair."

"How are her O2 sats?" Elsie said, turning to John. He nodded, glancing at his monitor.

"She's stable."

"Alright. I'm going to transect the falciform ligament — Dr. Hughes, apply downward traction —"

She watched as his nimble fingers slipped aside the organ – and it was so small, everything about the procedure was on a child-sized scale. And yet there he was with his enormous paws, somehow delicately maneuvering the tools in and around the doll-sized organs with tenderness that couldn't be taught.

"I'll repair this laceration here," he said pointing, "with polypropylene sutures. We'll insert a drain to be removed in a few days. I don't have even the slightest hesitation knowing that she'll be in your unit for her post-operative course. She'll heal nicely under your watchful eye."

It was a peace offering and she hoped she could see the smile in her eyes; the only part of her face not obscure by a surgical mask.

"As always I appreciate your vote of confidence, Dr. Carson." she said quietly, "I admit I am finding myself most impressed with your prowess, working on much smaller organs than you're accustomed to, I suspect."

He chuckled, pulling the thick suturing up, "A bit smaller, yes."

Elsie looked down at the child's face, her eyelids fluttering beneath the tape used to keep them closed. "Do you really think someone could have done this to her intentionally?"

Charles shrugged, "I can't rule it out. If it was really the work of a bicycle kickstand than it was one hell of a freak accident." he flicked his eyes up at her, pausing in his suturing, "Do you think it's wrong of me to have the parent's questioned?"

She shook her head slowly, "I suppose it's better to do so and then learn you're wrong . . .though it will be traumatic for them to feel they're being investigated while their child is undergoing major surgery."

"I suppose. Though if my suspicion proves correct—" he finished his suturing with a quick tie and dropped the tool in a waiting bin, a dull clink as metal fell against metal, "I'll have saved her two-fold"

* * *

"Got a light?"

Thomas Barrow turned around, the late afternoon sun stinging his eyes as he struggled to make out the face of the women who had appeared next to him on the hospital's rooftop helipad.

"Oh, it's only _you._" he said, his cigarette bouncing on his lip as he fished his lighter from his front shirt pocket. "You on break?"

Sarah caught the lighter as he tossed it to her, taking her cigarettes from her smock. "Just a fifteen — been out straight all day. One fucking thing after another."

Thomas exhaled, "If you wanted peace and quiet you shouldn't have applied to be unit secretary on the surgical ward."

"What, and hang out in geriatrics with a bunch of old codgers trying to feel me up every five seconds? No fucking thank you."

"You could have been on pedes with me."

"With a bunch of screeching, twee little twerps? I don't think so. I can't believe you've lasted this long yourself."

"It's not so bad," Thoma said, pitching his cigarette against the concrete and stubbing it out with his shoe.

"How does the Scottish Dragon treat ya?" Sarah said, taking a long drag, "I've heard she's a right bitch when she wants to be."

Smiling, Thomas took his lighter back from Sarah's extended hand, dropping it into his pant's pocket. "She doesn't even know I exist."

* * *

*There are several types of pneumothorax, essentially this happens when there is blood/fluid/air in the chest that needs to be relieved in order to take pressure off the heart, lungs, trachea, etc. I had to guess that in a penetrating injury that was also sort of a blunt-force trauma, also considering that children have more cartilage and therefore don't break ribs as easily, a tension pneumothorax would occur. Research seemed to support this theory but, as always, I'm not a doctor lol I just play one on tumblr.

*Pericardiocentesis is actually only done blind in an emergency situation and if the doctor is very skilled — if it had been anyone else but Charles/Elsie (who are presumably the most experienced physicians in the hospital) they wouldn't have attempted it without ultrasound guidance.

*Again, there are lots of different kinds of regional anesthesia, but for surgery that involves your chest/trunk they usually use a peripheral nerve block. Also, given that it was an emergency surgery and they didn't really have a plan, they wouldn't have had time to discuss other options and from what I read this is a pretty good option, particularly with kids (who are, of course, anatomically different from adults)

*I couldn't decide if he'd have done this or a median sternotomy (when you cut directly down the length of the breast bone, crack it, and open it up ala open-heart surgery) I ultimately went with this because, if the diaphragm needed to be stitched up, he'd probably have wanted to go with the direct route — and your diaphragm is kind of off to one-side, not dead set in the middle.

*I've observed a surgery where a bone saw was involved and I can tell you that this scent is one you don't soon forget. It's sort of like burnt hair smell, but different. . .burning flesh has a very distinct, hot, almost like burnt rubber smell. Anyway, it's memorable.

*I believe this is the saw you use for this — the only time I've seen one in action was during an autopsy and, of course, since the patient was dead it really didn't matter what saw was used, but I believe when you're going through ribs you use this saw — it's not like a table saw or anything, haha. Think smaller.


	6. Night Shift

As Elsie locked up her office for the night, having vowed not to sleep in an on-call room two nights in a row, she felt her eyes dampening. It had been a long day, it was late and she would get home and practically turn right back around again to be back in her office by 6 am. The click of her thick heels against the linoleum was almost deafening as she made her way through the main corridor to the employee parking lot. It was nearly 9 o'clock and she'd only just finished documenting. Unlike many physicians, she made a point of not leaving her office until all her charting was done. She watched, somewhat horrified, as the younger physicians would routinely allow their patient documentation to pile up for weeks or even months. Back when she'd been a young resident, one of the only female residents at Downton for that matter, she never would have dreamed of attempting to squeak by with such laziness. Not least of all because the younger physicians had technology by their side. While she did keep handwritten notes and charts on her patients out of habit and preference, she didn't need to. The new electronic records weren't perfect, but they had promise. So much about medicine and technology had promise, but on the days when everything seemed to go wrong and she felt all at once very alone, it was hard to keep such a sentiment in mind.

Her patients were stable, which was more than could be said for her nerves. As she walked across the parking lot to her car she clenched and unclenched her fists against the cold air. Fishing her keys out of her purse, she pressed her body up against the side of her car — the only thing that kept her from losing her footing as she whipped around to defend herself as a hand tapped her shoulder.

"Jesus!" she said, her keys jingling as her hand pressed to her chest, "Dr. Carson you scared me half to death. Whatever made you think it would be a good idea to spook a woman who is alone in a dark parking lot this time of night?"

Charles blinked at her in the darkness, half his face illuminated by one of the street lamps behind them. "I'm sorry — I just — I was getting into my car and I saw you. It's awfully late."

"I had charting to do." she said quietly, "It's been a long day."

"Yes, it has."

There was a moment of strained silence between them as he reached up to muss his hair a bit.

She sighed, turning to open her car door. "Well, you must want to be getting home yourself."

"Yes — on my way, but — Dr. Hughes, I just wanted to thank you for scrubbing in on the trauma today."

"Well . . .it was hardly an inconvenience." she said, giving him a brief smile, "You did marvelous work. As always. The patient's family is very grateful. She'll make a full recovery."

Even in the dark she could tell his cheeks had pinked up at the compliment. Perhaps it was her fatigue but the thought of it almost made the man — who towered over her in height and frame — appear rather adorable.

"I know we had a row this morning and — well, I wanted you to know that I went to Dean Crawley and made sure that he launches a thorough investigation into your access audit. We _will_ get to the bottom of it." he sighed, his eyes softening, "I am on your side, Dr. Hughes."

"Thank you, Dr. Carson. I appreciate that."

"I —" he hesitated, choosing his words thoughtfully. "I think we make an excellent team."

She held his gaze a moment, her lips curling up into a little grin. He smiled back, and reached over to open her car door.

* * *

"Did something happen with Mary today?" Cora asked as Robert slid into bed next to her, "She sounded very upset when she called to say she wasn't coming for dinner."

Robert sighed, fluffing his pillow with a bit more gusto than was required.

"A transplant patient rejected the heart and Dr. Carson removed her from the case."

"Did she do something wrong?"

Robert sighed, "It's not quite that simple."

Cora pursed her lips, "I may not have a medical degree Robert, but considering I'm married to a doctor and two of my three daughters are doctors themselves I'm confident I can understand."

He looked at her sheepishly, "I'm sorry — it's just. . .it was a very tiring day. Even more troublesome than Mary's patient — I think we've had a security breach. Either that or Dr. Hughes has incipient dementia."

"_What_?"

Robert shook his head, "That was a rather tasteless remark — but—" he sunk deeper into the blankets, "A patient of hers was transferred and she claims that she never authorized it. Now, the transfer summary had been dictated and signed off by her — or, I suppose, someone pretending to be her. When the records department ran an access audit after she reported it — well, nothing appeared to be amiss. I suppose I have to take her word for it that she didn't authorize the transfer — I just hope that if there has been a breach we're able to track it before more events like this pop up."

"Do you really think she'd discharge a patient and then forget, Robert? I know she's been a doctor a long time but — your mother is older by a leap and she's still practically running the _entire_ healthcare system."

"I don't know, darling." he said quietly, "Anyway, did Sybil say if she needs to be picked up at the airport? Can you handle that or — isn't Friday evening your cooking class?"

"No, book club. I could skip it if she needs a ride. She didn't mention it but I suppose one of her friends could. She might prefer that."

"I'm sorry I was cross earlier. Though I still don't think she ought to have a completely _useless_ holiday. If she doesn't want to shadow Mary, fine. But she should at least log a few hours in the ER. She seemed to like that well enough last summer."

Cora smirked, "Particularly the ambulance ride-alongs."

Robert gave her a look, "If she wants to specialize in emergency medicine that's one thing but I doubt she'd be content to be an EMT."

She ran her hand across the cool sheets of the bed, letting it come to settle on his upper thigh. "I don't think it's the _medicine_ that interested her."

"I don't know what you mean," Robert said, "But I _do_ know that I have done nothing but talk all day and right now I would very much like to do _anything_ else."

Leaning over, she gently kissed his lips. "Did you have something in mind or are you open to suggestions?"

He smiled against her mouth, running his hands along both sides her ribcage, bunching her nightgown against her hips. "Something tells me we're thinking the same thing."

* * *

Mary stood above William Mason's bed, peering down at his chart to study his most recent vitals. It was late and the night shift staff were just coming on, meaning she had a moment or two to sneak in undiscovered. The numbers blurred on the page and she squinted harder. She often felt that she'd stopped actually achieving REM sleep back in med school and had, for the better part of the last decade, been adapting to sleep deprivation. Up until now she'd been rather proud of the amount she'd been able to achieve despite it, but with this case she'd been forced to reflect. Perhaps she wasn't successful at all; just lucky.

The door to William's room opened and she startled, the chart bowing in her hands, loose nursing notes drifting to the floor. She scrambled to pick them up and as she turned and stood, she found herself face to face with the _Other Dr. Crawley_, Matthew; her replacement on the case.

"Dr. Crawley?" he said, hanging back as though he expected she'd pounce, "I'm sorry, Dr. Carson said you were off the case —"

"I am," Mary said quickly. "Contrary to popular belief I do, however, have a heart of my own and before I went home for the evening I wanted to check in."

Matthew raised an eyebrow, "You sure you weren't just checking on _me_?"

"No, Dr. Crawley. I merely wanted to know that the patient was stable. I have the utmost confidence in Dr. Carson and if he feels that you are suited to the case I have no choice but to believe him." she walked toward him, her spine straight, and dropped the chart lazily into his hands. "I'll leave you to it."

"Dr. Crawley?" Matthew said, turning, "I suspect that I would have done the same. If it had been me."

Mary paused, her hand on the door. "What's that?"

"If I'd been replaced on a case of this . . . magnitude. I'd have snuck in to see that things were being handled to my standards."

"It's not about _my_ standards, Dr. Crawley — it's about Downton's."

Matthew smiled knowingly, lowering his gaze. "Is there a difference?"

Despite herself, Mary allowed herself a small smile. Matthew didn't see it, however, because by the time he'd lifted his gaze all he saw was the back of her head disappearing into the hallway.

* * *

Phyllis Baxter stifled a yawn as she opened the door to her last patient of the night. Her shift had technically ended a half hour ago, but there had been a few new admits to the unit in the afternoon so she wanted to be sure they were well tended to before the night nurses came on.

"Ruth?" she said stepping into the dimly lit room. The patient had been admitted from the emergency room earlier, having stumped the emergency room physician with her symptoms. Clearly exhausted, the girl offered a smile to the nurse, sliding her glasses up her nose.

"Hi," she said quietly.

"I just wanted to check on you one last time before the end of my shift. The night nurses will come in to check your vitals and you'll see Dr. Hughes first thing in the morning. I'm sorry she didn't have a chance to come earlier, when your parents were still here. It's been quite an eventful day."

"It's okay," Ruth said, pulling the covers up a bit. "I got to sleep some."

"Good." Phyllis smiled, "Can I get you anything? A cup of tea?"

"Well, would you mind taking a look at this?" Ruth winced, raising her arm. "I wasn't sure if it was normal. You know, for it to hurt so much."

Phyllis came to the edge of the girl's bed, turning on the lamps behind the bed. The girl lifted her arm into the light, gently steadying the weight with her other.

"Oh dear," Phyllis swallowed, inspecting the girl's IV site.

"I didn't want to bother anyone about it but — it _really_ hurts." Ruth said, turning her head away. Phyllis grimaced as she sighed.

She wouldn't be headed home for a while yet.

* * *

Tom had fallen asleep as soon as his head hit the pillow. Even though his roommates — all four of them, tucked into their tiny flat — were having a bit of a wild night, Tom managed to sleep straight through it. What did manage to wake him was the vibration of his cell phone, positioned rather close to his skull as it was. The sound of it, like a jackhammer in his ear, made him bolt upright.

"_Fuck!_" he groaned, sinking back down and rolling over to check. Even though he was perturbed at his sleep being interrupted, once he saw why, he couldn't help but grin.

_SYBIL (9:42 pm) : Hope you're not asleep! Just have a quick question._

_TOM: (9:43 pm) Not sleeping anymore, haha. Shoot. :)_

_SYBIL: (9:45 pm) Can you maybe pick me up at the airport Friday? I don't know what your schedule is like and I'm sure my mum can if you aren't available, but I thought maybe it would give us some time to catch up._

_TOM: (9:46 pm) Friday's my day off :P What time?_

_SYBIL: (9:48 pm) 3'o clock in the afternoon. Gate B. Don't pick me up in the ambulance though._

_TOM: (9:50 pm) You ruin all the fun! I'm still looking forward to hanging out though. Are you gonna hang out in the ER again?_

_SYBIL: (9:51 pm) Dad wants me to shadow Mary but I told mum, like I am noping the fuck out of that. I would totally be down to shadow in the ED. Mostly I just want to sleep and like . . .play Minecraft. Is that terrible?_

Tom actually laughed, shaking his head lightly. He knew he was falling for the girl but he hadn't realized quite how fast.

_TOM: (9:54 pm) Not terrible..._

_TOM: (9:55 pm) Adorable :) _


	7. Flesh and Blood

_Hi guys! Thank you, thank you for all your continued love here and on Tumblr for this story! The pacing is slowing down a little bit because I'm trying to introduce a few new plots and also tie up some that were already started. Remember, we're six chapters in and we're only one Day 2, haha. Not sure what the timeline will be — may skip ahead a few months here or there, depending on patients and medical necessities. This one isn't too medicine heavy — but Dr. Hughes has a consult next chapter so bone up on your medical terminology until then! Haha. 3 Also thank you to olehistorian and silhouettedswallow who talked to me about "britpicking" for the American vs. British colloquialisms — and all of you that offered to britpick for me! Definitely let me know if I've missed something, I find it rather fascinating and am eager to learn!_

* * *

If anyone noticed that Phyllis Baxter was nearly always the first to arrive on the pedes ward each morning, they never commented on it. She stepped through the front door to the hospital each day precisely twenty minutes ahead of schedule. She needed the quarter hour or so to herself to change out of her street clothes into her scrubs and stand in the sterile quiet of the women's locker room for a moment. She would tighten the neat bun she wore her hair in — identical to any other day. Smooth out the wrinkles in her scrub bottoms. Maybe, if she was feeling particularly good, dab on just the tiniest bit of lip color.

As she made her way through the narrow hallway to the back entrance to the unit, which was connected to the long underbelly of a hallway to the operating theatre, she would often rap lightly on the doors to the on-call rooms, gently alerting the occupants that a new day had begun.

Having left a quite a bit later than usual the night before, she happened to know for a fact that John Bates was in on-call room number 3. Whether or not he was alone was anyone's guess and while she knew it wasn't her business, what she _did_ know was that there was a good chance her right-hand nurse on the unit was in there with him. And her day couldn't properly begin without her.

She paused in front of the door, raising her hand to knock just as it flung open. Anna, as predicted, stood in the doorway, hair disheveled and her skin pink and slightly aglow. She held a scratchy cot blanket against her, probably to hide the fact that she clearly was not wearing a bra, and startled when she nearly ran straight into Phyllis.

"I thought I'd be able to sneak out before you started your morning round," Anna said, a sleepy but satisfied smile on her face.

Phyllis blushed. Even though she had suspected as much, actually catching the two somewhat _in the act_ managed to embarrass her. Even the suggestion of fraternization made her heart flutter.

"My lips are sealed," she said quietly, not looking at Anna's face.

"Thank you," Anna laughed, "Do you have another hair band*? I seem to have misplaced mine. . ."

"There's one or two in my locker — you know the combination." Phyllis smiled, giving her a slight wink.

"Coffee's on me later, okay?" Anna said as she took off down the hall. Phyllis laughed, shaking her head slightly.

It must be rather nice to . . ._lose one's hair ties._

* * *

The kettle whistled just as Elsie lifted the mascara wand to her eyelashes.

"_Drat,_" she said, poking herself. Recoiling from the mirror she gently ran the pad of her finger on the mussed up smudge of her eyelid, trying to salvage her cosmetic handiwork. She never wore much makeup, even less now that she was getting on in years. What was the point? She'd spent hours of her youth painting her face for men who never gave her so much as a passing glance. It wasn't apt to change now. Mostly the rogue, mascara and swipe or two of lipstick she wore was to make herself presentable to patients — no one else's opinion mattered.

Barefoot, save for her stockings, she padded quietly into the kitchen, turning off the stove and lifting the simmering kettle to fix her tea. Milk already poured, she blinked as the steam lifted up from the cup and flushed her face. Her same cup of tea, in the same Spode china cup (her mother's) which would, in a moment's time, be stained at the rim with her lipstick (the same color she'd worn for the last twenty years: _Rosewood _by Max Factor. Or, some iteration of it from Boots.)

She didn't necessarily _mind _that things in her life outside the hospital were consistent; it certainly made up for the chaos within the walls of her place of employment. Never knowing on a given day what she'll face, either from her staff or her patients. Coming home each night (that is to say, when she managed not to slip into an on-call room) to the small comforts her routine afforded her was something that she wouldn't _dream_ of giving up. Though, at times over the years she'd wished she had _someone _to come home to. She didn't let herself get lost in thought about such a folly — she was _long _past her prime — but occasionally she'd have the telly on while she did the dishes, or be reading a few pages of a novel before bed, and she would wonder what it would be like to have someone to turn to. To mull over her day with.

To climb into bed next to each night.

With a quick flick of her wrist, she glanced down at her watch. Lost in her own thoughts for so long her tea had begun to grow cold and if she didn't gather up her briefcase and get going, she'd be late. Leaving all but a few sips of her tea, she shrugged. She knew a certain doctor would be waltzing into her office with a cup of coffee within the hour; the one moment throughout her day that could always be counted on.

* * *

Across town in his two-bedroom walk-up, Charles hummed as he tied his necktie, flipping it through its loop with a flourish. He nodded slightly at his reflection in the mirror — not a young man by any means, but a seasoned attractiveness about him. Turning back to his bed, neatly made as he did every morning the moment he rose from it, he examined the contents of his briefcase methodically: his note keeper, the blasted tablet computer the hospital enforced him using, a leather bound day planner, his mobile phone, and a novel he'd _say _he was going to thumb through on his lunch — but never did. He regarded each piece as though it carried twice its weight as it set it gently into the briefcase. Satisfied with its tidiness, he shut the lid and snapped it shut. Turning back to the mirror, he straightened his suit jacket and sighed.

He wasn't sure when, precisely, he'd become an old man but it _had_ happened. As he walked downstairs, his knees cracked, echoing the sentiment. Looking around at his kitchen — breakfast dishes done, everything in its place, the sink sparkling in the early morning light beginning to fill the room — he closed his eyes a moment and wondered what it would be like to cross the tile floor, wrap his arms around the waist of a woman whose bed he shared, kiss her cheek — _affectionately tap her bum, perhaps_ — and leave for work knowing he'd have her sweetness to come home to.

The thought never lingered long. Though, for reasons he had not yet untangled, as of late he seemed that as he was leaving home each morning there was a faint echo calling him back; a throaty, Scottish lilt.

* * *

Years of getting three girls and one husband off each day left Cora perpetually unable to sleep much past 5 o'clock in the morning. It didn't bother her that much, really. She enjoyed having an hour or so to herself. She'd slip from bed, smoothing Robert's night-mussed hair from his forehead and kissing him sweetly, heading into the bathroom to wash her face.

As soon as she crossed the room, she was hit with a wave of dizziness. It was the third morning in a row rising from bed had given her a head rush. Leaning against the door frame, she closed her eyes and waited for it to abate. Taking a tentative step into the bathroom, she flipped on the overhead light and squinted into the mirror.

She looked a bit poorly, her eyes puffy and almost gray. Sighing, she turned to grab her robe from the back of the door and the reflection of her figure in profile caught her eye. Pausing, she turned on her heels slowly back to face it. She reached down and tugged her nightgown over her middle, pressing a finger into the flesh that seemed, somehow, more _present_ than she remembered.

_Middle age paunch! _She thought wearily. Letting the fabric fall around her, she shook her head and pulled her robe firmly from its hanger, wrapping it tightly around herself.

Perhaps she would _not _have toast for breakfast.

* * *

"Does she do this _every _morning?" Daisy whispered, leaning closer to Anna as they surveyed the spread of baked goods Beryl had set out at the nurse's station.

Anna bit her thumbnail, shaking her head slightly. "No — only when she's riled up about something. . ."

Daisy swallowed hard, "I hope it's not me! I hope I've not put her off already!"

Giving her a reassuring smile, Anna pet the girl's arm. "Don't worry, you haven't been here long enough to do that. Trust me." Flicking her gaze back to the computer, she sighed. "I've got to go take the new admit's vitals — care to join me?"

Her newest "charge" in tow, Anna headed down the corridor to Room 24. The newest addition to the pediatric ward had come in yesterday and gotten a bit lost in the shuffle of so many traumas. Her name was Ruth. Per Phyllis' nursing notes from the night before, it looked as though Ruth's course was shaping up to be a most difficult one; she hadn't even been in the hospital one night and already her veins had collapsed, making the insertion of an IV precarious. Phyllis had tried various sites for the better part of an hour, and had gone home not entirely satisfied with her work. Ruth had been patient, though, even though she was visibly pained by the prodding.

When Anna and Daisy entered her room, Ruth was already awake. She hadn't yet sat up in bed, but she smiled sleepily at them.

"Two of you?" she said, her voice still thick with sleep. "That poor nurse last night must have given up on me."

"Not at all, Ruth. She'll be in later to check on you, I'm sure." Anna said, "How are you feeling?"

The girl pushed herself up in the bed, wincing slightly. "A bit parched. And my arm is still —" she held it out for Anna to inspect.

"Well, Daisy can fetch you a glass of water while I take a look at your IV," she turned to Daisy, "Would you mind?"

The nurse grinned, happy to be useful.

"Dr. Hughes will be in to see you as soon as she arrives," Anna said, "From your chart it looks like you had quite an eventful day yesterday."

Ruth sighed, "I guess. I haven't felt great for a couple of weeks but I passed out at school yesterday and everyone freaked out."

"Have you felt at all faint since you were admitted?"

"No, but I haven't really gotten up much —"

"Well, ring your bell if you need to get up to go to the loo. We don't want you falling down."

"Thank you," Ruth said quietly. "Has my mum come by yet?"

Daisy placed a small glass of water and a pitcher on the table next to Ruth's bed, "I can go check?" she said to Anna.

"Thank you, Daisy."

Anna turned back to Ruth, "Let's have another go at this IV, yeah?"

* * *

The sun had risen high over top of the Downton campus, shining directly into the eyes of Violet Crawley as she rounded the corner of the path that snaked around and through the hospital's grounds.

"I should have worn sunglasses," she grumbled. Isobel, who kept stride next to her, arms swinging, laughed.

"You don't even _own_ a pair!"

"I certainly do. I just don't make a habit of wearing them in public."

"Isn't that rather the point of them — to shade ones eyes from the glaring sun?"

"Indeed, but at the cost of looking like a fool."

Isobel, who _was_ wearing a pair, gave her a look. "I suppose squinting does not?"

"Not at all. Quite the contrary. It makes me look as though I'm immediately displeased with anyone I encounter."

Isobel laughed, "Resting bitch-face."

"What?" Violet said, turning sharply toward her as she stopped walking.

"That's what the kids call it — _resting bitch-face._"

"How tragic." Violet said, picking up her steps again, "Though I suppose there are worse expressions one could be stuck with. There are a few interns this year who appear to have foolish grins lacquered on."

"The patients must find it pleasant, though."

"Oh yes — '_Mr Jones, you've got Polycythemia vera, but look at my aggressively white teeth! Do they not fill you with joy?!' "_

"You're too much," Isobel said, grinning. "Speaking of the kids, would you be completely offended if I asked how Matthew is performing?"

"I'm impressed, Isobel." Violet said over the sound of her feet crunching along the gravel as they turned onto a new path. "We actually managed to have a few exchanges before you turned the conversation to your son."

"If you'd rather not indulge me, I understand. I know better than anyone your limitations on discussing hospital matters outside of the C-Suite*."

"Well, I suppose you already know that he was put on Mary's heart transplant case."

"Yes, I heard."

"Dr. Carson removed her from it rather forcefully."

"Well, I would think to remove Mary from any case one would have to rip it from her cold, dead hands." Isobel chuckled.

"There's a first time for everything," Violet said levelly, "But if Mary wants to continue to rise in the ranks she's going to need to be certain that it is her first and _last _such error."

"Don't you think that's rather an impossible standard?"

"No, as a matter of fact I don't." Violet said, "And I'll say this about your Matthew: he may not be a Downton Crawley, but if he plays his cards right and continues to give Mary a run for her money — I suspect that he will assimilate rather seamlessly."

"Well, I'm very pleased to hear it. Though I wouldn't want their competition to come between _us_."

"Oh, don't." Violet chortled, "You know how your insecurities bore me."

Isobel smiled as they stepped around the corner, having made a full loop. As they headed for Downton's front entrance, the sun peaked out from the awning, turning her Chanel shades-tinted vision gold.

* * *

_*apparently some people call them bobbles? I couldn't figure out what you UK folk call 'em. I just call 'em hair ties, honestly. Or hair elastics. Never scrunchies unless they are those 80's tastic frilly things._

_*C-Suite is just a term for the executives in an organization, the CEO, CMO, CIO, CFO, etc. _


	8. Head Rush

Hi, hi, hi! As always thank you so much for continuing to support this story with all your amazing ideas and your lovely reviews and all the interactions we have on Tumblr. I love that this story is becoming a true collaborative effort and I see it going on, hopefully, for a long long time!

* * *

"Ros, you better not be here because Edith's cocked up Psych. Between Mary's dismissal from her transplant and Sybil's apparent disdain for medicine on the whole I really, really can't take another _daughtorial_ disaster today."

Knowing her brother well, or rather, as well as an older sister ever knew her sibling, Rosamund shrugged as she plopped herself down in one of his leather office chairs. "I'm not even here about Edith," she said, "Can't a sister come visit her brother who also happens to be her boss?"

"Much as it pains you to admit it," he smirked, looking momentarily up from his schedule. "I've got to run off to a meeting soon here, so get on with it."

She sighed dramatically, making a show of rolling her eyes. "Well, if you're not even all that interested in what I've to say I'll just go. Wouldn't want to waste your time or suck up all the air in your office."

"What do you want?" he said, folding his hands on his desk and pushing away his planner. "I'm listening. Truly, I am."

"_I_ don't want anything," she said, "But _you_ will want to hear what I've to tell you."

"Did you really come in here, at eight in the morning, to gossip?"

"It's not gossip, Robert, it's _intel._"

Robert scoffed, "Are you going to make me beg? Christ, get on with it!"

She paused for effect, dabbing at her lipstick with her pinky. Then, she cleared her throat ceremoniously. "I do believe that we have a bit of fraternization happening at Downton."

"Oh?" Robert said, feigning amusement. "Pray tell — where is the boffing occurring?"

"Pedes, I believe."

"For the love of God and all that is holy please tell me this isn't with patients—"

"Oh, Robert! No." Rosamund said, "Guess."

"I don't have time to guess. . ."

"Oh, c'mon!"

Robert sighed, "I don't know — probably that Molesley character. The male nurse on that unit? He's got a suave look about him. Something about his hair. He looks sort of _exotic._"

"That was a pathetic guess. Think harder."

His eyebrows shot up, "Well you can't be talking about Charles Carson—"

Rosamund guffawed, "And Dr. Hughes? _The Scottish Dragon_? Well, I think we all know they've been shagging for thirty bloody years."

Robert nodded, "Fair enough. Who does that leave?"

Rosamund folded her arms neatly across her chest.

"Oh — that anesthesiologist bloke. Bates? I've seen him around with the little blonde nurse, what's her name?"

"Anna,"

"Yes, yes. She seems nice, _fit. _Can see why he likes her."

"Don't let Cora hear you talk like that,"

Robert gave her a look, "Don't be stupid."

"I'm not — you'd break her delicate little colonial heart. . ."

"Is that all you came to tell me? That the anesthesiologist is snogging a nurse? Honestly, Rosamund. We've spent our entire lives at this hospital — don't you think I know that there are more than a few scandals in these halls?"

Rosamund stood up, smoothing her pencil skirt. "I just think you'd better keep an eye on it, that's all."

"Why? Are you after Dr. Bates?"

Rosamund laughed, opening the door to his office. "The gimp? Of course not. I just don't think sex in on-call rooms should be encouraged."

Robert chuckled, opening his planner again. "You're just bitter because _you've _never left your knickers in an on-call room."

Turning back from the door, Rosamund glared at her brother who only looked up long enough to give her a cheeky grin.

Preparing to whale the door shut behind her, the last he heard as she left his office was, "Sod off Robert!"

* * *

"I would like to speak with a colleague of mine before making a definitive diagnosis, but I believe I do have some idea what is causing Ruth's symptoms." Elsie said, closing the girl's chart and folding her hands neatly atop it. Ruth's parents, who had been silent but eagerly listening for the better part of a quarter-hour, became suddenly quite animated. The room had been teeming with anxiety as soon as Elsie set foot inside, and she'd hoped to have quelled with a firm diagnosis — but Ruth's case was not quite so simple. As her parents grew antsier, the teenager could only offer Elsie a look of exhausted, and perhaps resigned, repose.

"Is it anything terrible?" Ruth's father said, "She's just had a spell, doesn't that happen to girls from time to time?"

"Right," Ruth's mother said, turning to Elsie, "Maybe she's not eating well or her periods are heavy—"

"Mum, _jesus._" Ruth said, the first she'd spoken since Elsie came in.

"Well, it _could _be any number of things, but there are a few things in Ruth's case that just don't add up." Elsie said, "The first of which is that this morning her urine was _very _off color." she turned to the girl then, "Has that happened before, Ruth? Particularly right when you've woken up in the morning?"

The girl blushed, looking as though she'd rather be anywhere than discussing intimate bodily functions in front of her parents and a complete stranger old enough to be her grandmother.

"Well, yeah — I mean, like. . .I guess it's happened a couple of times. I just thought maybe I'd had some . . .like, spotting." she said, swallowing her words self-consciously.

Elsie nodded, making a note in her chart. "When we tested your urine this morning, Ruth, we found that it had hemoglobin in it."

"Hemo — like blood?" Ruth's father said, beginning to wring his hands.

"Well, not exactly." Elsie said, "It's not quite the same thing as having blood in your urine like you might, say, if you had a kidney stone. It's more. . ." she thought a moment, licking her lips contemplatively, "Think more microscopic. The problem, I think, is on _that _level."

Ruth's parents just nodded, returning to uncomfortable silence. From where she sat upright in bed, Ruth herself began to look worn and maybe a bit peckish.

"Have you had an illness or injury recently, Ruth? Like, a bad flu or a bump on the head? Or, maybe, are things rather stressful for you at school?"

Ruth shrugged, "Nothing that I can think of."

Elsie was unconvinced, but knew better than to expect a teenage girl to reveal much of anything while in the same room as her parents. She turned to them apologetically. "Would you two mind stepping out for a moment — I would like to ask Ruth a few more questions and they are — of an intimate nature."

"We will _not,"_ Ruth's father said, "There's nothing she could tell you that we shouldn't know, we're her parents for Christ's sake!"

"Darling," Ruth's mother said, setting her hand on his arm tentatively, "She probably wants to ask about her menstrual cycle and such. No need to get defensive, but I'm sure she doesn't want to talk about it in front of you." she gave her daughter a knowing glance, "Right, Ruthie?"

"Yeah, just go on Dad. It'll only be a minute."

"Any chance we could get a half-decent cuppa around here?" Ruth's mother said to Elsie.

"Sorry to say you'll be hard pressed for England's finest, but you can get something more or less palatable downstairs." Elsie smiled, standing and showing them both to the door.

"We'll be back in a jiff," Ruth's father said eying Elsie, meant more as a warning than words of reassurance. When they'd left and Elsie returned to her chair next to Ruth's bed, the girl gave her a small smile.

"He tends to get heated up over nothing," she said.

"Textbook presentation of a _father._" Elsie said, "It's only because he loves you."

"Yeah —well would it kill him to love me a little less?" Ruth said, rolling her eyes.

"Do you remember what you were doing before you fainted? How your day had been? Did you have a fight with a girlfriend, maybe? Or get a bad mark on an exam?"

"No, it was a pretty regular day." The girl thought a moment, then a small smile crossed her lips.

"The reason I'm asking is because the condition that I suspect you have is often made worse by sudden emotion— so, I'm just wondering if anything happened that day that could have stressed your body."

Ruth looked at her a moment, "Well, could it have been a _good _emotion?"

"I suppose," Elsie said, suddenly noticing the glint had returned to the girl's eye.

"Well, a boy I fancy asked me on date."

"Oh, I see." Elsie said, smile in spite of herself, "Pretty chuffed then were you?"

"I thought I felt woozy 'cause, you know they always say love makes you weak in the knees and all that, well, I thought maybe that was true."

Elsie chuckled, "Well, if I'm right then in your case_ it is,_ my dear." she stood, looking down at the girl encouragingly, "I'll step out and see if I can find the doctor I'd like to speak to about your case. And I won't tell your parents about your new beau."

Ruth smiled, "Thanks for that — I'd like to at least get _one_ date in before my Dad sends him to Coventry."

* * *

Cora stumbled out of the bathroom and dropped onto the bed in a heap. She didn't have time to be ill, not today! She had too much to do to prepare for Sybil to be home on holiday. There was laundry to do, groceries to buy – Robert had shirts that needed pressing and the dog, Isis, needed to go to the groomer. She'd managed to keep a good face until after Robert left for work, at which time she'd leaped up and just barely made it to the bathroom in time to be sick.

She reached over to her nightstand and groped for her cell phone. With the time difference it would be early, but her mother would still answer, knowing that Cora only ever called when there was trouble.

Martha Levinson picked up on the third ring.

"Hi Mom," Cora choked. She cleared her throat.

"You sound like shit," Martha said.

"Not even a hello back?"

"You're sick." Martha said, matter-of-factly. Cora heard the bed creak as she turned over. It would be just after five in the morning in America and her mother, a woman who demanded luxury, would usually not be awake for several more hours at least.

"When you went through menopause did you get sick?"

"What, like puking?"

"Yeah."

"No, but I had hot flashes. And I got fat. You can look forward to that, Cora. All the Levinson women ballooned after they lost their cycles. Would probably be just the thing for you, you've always been too damn skinny."

Cora hiccuped, "I — well, I think I've started the change but— well, I got sick this morning and have felt entirely off for a week."

"Ha! You pregnant?"

"Very funny."

"I guess it could be from the menopause — huh. You should probably go to the doctor anyway. They can test your hormones."

"I'd feel silly going just to confirm a natural process."

"Let me tell you a thing, darling: you're gonna want him to know before it gets any worse, because once you dry up there's a bunch of estrogen creams and pills that you'll be busting down his door to get—"

"Please," Cora laughed, "Let's not."

"You don't sound well _at all,_ Cora. Are you sure you haven't caught something?"

"I don't know, it's possible I guess. I just feel so tired. And I've got so much to do for when Sybil's home this weekend."

"I'm sure Robert's being as helpful as ever."

"He's busy. Things at the hospital have been–"

"I don't care," Martha yawned, "He's married to _you_, not Downton."

Cora didn't say anything, just sighed wearily.

"Cora, sometimes I think it'd be easier if he was cheating on you with a human woman rather than an institution of healing."

"Don't say that," Cora said, "I don't feel that way."

"Hm." Martha grunted, "In any case I still think you should go see your doctor. You're getting older, you can't ignore these things anymore. One of the women I play bridge with ignored all the weird symptoms she was having and she was dead in six months!_ Dead, _Cora!"

"_Mom_—"

"Besides, if you go to the hospital you might see your husband for once."

"Fine. I'll go."

"Good. Call me when you find something out — but preferably not so early."

"I know. Thanks."

"I love you."

"Love you too. Talk soon."

She squinted at the screen, sliding her finger across it until it finally hung up. She dropped the phone into her lap and closed her eyes, willing the nausea to abate. Then, she picked it back up and dialed Dr. Clarkson's office.

"Dr. Clarkson's office."

Cora smiled at the familiar voice, "Isobel what has he got you answering the phones for?"

"Oh, hello Cora." she said, "Our secretary had to go pick up her little girl from daycare. Got a bit of a fever."

"Oh dear."

"Yes, well, I'm putting my secretarial skills to good use. And I'm guessing you didn't call to chat?"

"No — no, I need an appointment to see Dr. Clarkson."

"Are you unwell?"

"I'm not sure. I mean — yes, I am, but I don't know if I ought to be concerned or not."

"What does Robert think?"

"He doesn't know and I'd prefer it if you didn't say anything."

"I see. Well, Dr. Clarkson's had a cancellation this afternoon. Could you stop by?"

"Yes, that would be wonderful. Thank you." Cora felt the room begin to spin again and she closed her eyes, trying to quell the wave of nausea.

"You're welcome, my dear. Looking forward to seeing you. It's been too long! Though, usually that's a good thing."

"Yes," Cora grimaced, "Well, I'll see you this afternoon."

She swallowed, pausing a moment before she dropped the phone without even attempting to end the call and made a mad dash for the bathroom.

* * *

"Where the _hell_ is Dr. Hughes?" Beryl hollered, pressing the phone receiver against her chest. Molesley, who happened to be the only person in the nurse's station besides the red-faced charge nurse, gave her a wide-eyed shrug.

"I think she went off for a consult with Dr. Carson."

"Oh,_ a consult!_ Well! No surprise there. I wonder what she's getting his _medical opinion _on today — her bloody lipstick?"

Anna came around the corner, giving Molesley an apologetic smile.

"Beryl, what's the matter?"

"They've got a case in the ED and they've been paging Dr. Hughes for fifteen minutes. I don't know where she's gotten off to but Mr Molesley here seems to think that she's with Dr. Carson—_again_."

Anna nodded, "She is, she went off to his office to consult with him on Ruth's case. I'm sure she's heard the page and is probably on her way across campus to the emergency department as we speak."

Beryl pressed her hand over the receiver and leaned over the desk closer to Anna, "She had bloody better be — and while we're at it, we ought to just call a spade a spade and call her out on all these _consults_ with Dr. Carson — if they're _actually_ talking about a case I'll eat my _christly _scrub cap!"

"I'm sure Dr. Hughes is on her way to the ED right now," Anna repeated levelly, "Go on and tell them not to get their knickers in a twist."

Beryl gave the nurse an annoyed glance and then huffed, placing the receiver back to her ear. "She'll be up in a bloody minute!" and with that, she slammed the phone back down, then turned to Molesley.

"What're you gawking at? Go change a bedpan or something."

Giving her a slightly nod, he scampered off down the hall. Beryl shook her head and turned back to Anna, who was trying to hide her giggling.

"You might be too _mooney-eyed_ over that anesthesiologist to see it, but I swear on my dear mother's grave that Dr. Hughes and Dr. Carson have been secretly romping since_ at least_ 1987!"

"I think they're just good friends and esteemed colleagues," Anna said, "They're like. . .the hospital's mom and dad, in a way. Looking out for everyone and all."

"And what does that make me, then— dare I ask?" Beryl said, hands on her hips.

Anna pursed her lips and looked up at her with a wide grin, "You're the aunt that gets drunk and ruins Christmas."

The two nurses looked at one another a moment and then erupted into a fit of laughter so loud that they didn't even hear the overhead page,

_Dr. Hughes to the ED, STAT. Dr. Hughes to the ED, STAT. _


	9. Weak Spot

Hello my lovelies! Thank you, thank you, thank you for all your reviews here and on tumblr. You are the light of my lifeeeee 3

* * *

"Paroxysmal nocturnal hemoglobinuria?" Carson said, looking up from Ruth's chart. He shook his head dismissively, dropping the folder onto his desk. "That's a reach at best, Dr. Hughes."

"She fits the clinical profile." Elsie said, reaching across his desk to retrieve Ruth's folder. She studied it again, sighing.

"Well, what triggered it?"

Elsie smiled, "Vasovagal reaction to . . ._a flirtation_."

Dr. Carson's eyebrow shot up, "Did you write that in her chart?"

She gave him a look, "A boy at school she fancies asked her on a date. The elevation in heart rate triggered the syncope. She's had the urinary symptoms for a while on and off, but had largely disregarded them."

The telephone ringing interrupted her thoughts. Dr. Carson held up a finger and answered it.

"She's right here, why? Yes, well — no, no. It hasn't worked for a week. I put a call in to facilities." he furrowed his brow, looking over at her, "Hold on, I'll ask." he placed the phone's receiver against his shoulder. "Have you been ignoring your pages?"

"I most certainly have not! I haven't _been _paged."

"Yes you have — to the ED. They've been paging you nonstop for a quarter-hour."

"Well, I didn't hear it on the overhead."

"No, I'm afraid you wouldn't. The one in here isn't working. Check your pager?"

Unconvinced, she reached into the front pocket of her white coat and took out the small, black gadget. She squinted a moment, then blanched.

"It's _dead_."

"Dead?" Dr. Carson said. He pressed the phone back to his ear, "She'll be up in a moment." he hung up, leaning toward her. "What do you mean?"

"The damn thing doesn't hold a bloody charge!" she stood, huffing as she stuffed it back into her pocket, "I'd be better off if they sent up a flare when they needed me."

Dr. Carson pressed his lips together in a thin line to keep from smiling.

"Technology makes you rather cheeky, doesn't it?"

She slapped her hands against the sides of her thighs and shrugged dramatically, "Only when it doesn't work!"

Once she'd left his office and he heard the trail of her heels clicking away down the hallway, he allowed himself a small chuckle. Who would have thought the way to vanquish the Scottish Dragon was a dodgy pager?

* * *

"Margie, can I come in?"

Edith rocked back on her heels as she stood somewhat awkwardly in the doorway. The woman looked up from where she sat, and had been sitting for several hours, on the bed and gave no indication either way. So, Edith took her chances and stepped inside.

"How are you feeling this morning?"

Margie didn't speak, only stared at Edith vacantly.

"I had a nice chat with your husband yesterday."

The room, small, sterile and sparse, seemed to only echo the emptiness Margie Drewe swelled with. It made Edith's heart tighten and while she knew she would eventually develop some much-needed clinical detachment, she wasn't there yet.

"He's relieved to know you're being well cared for here. I do hope you would agree with that assessment. Feel that you are being well cared for?"

Edith couldn't be certain but she thought she almost saw a slight wince in Margie's face. Though she easily could have imagined it.

"Well, I hope that you are feeling safe here. That's our top priority. That and getting you better so that you can go home with your children."

Margie looked up sharply, "Have you taken Marigold?"

Surprised to hear her voice clap loudly in the room, Edith couldn't help but jump.

"I — Margie—"

"She isn't anywhere here. She was in bed with me last night and gone when I woke up this morning. I thought she might be off playing but I looked and looked. Did you take her away?"

Edith's heart began to race. Should she engage in the delusion in order to learn more about it or press Margie to see if she was aware that it was only a delusion that she held.

"Perhaps I can help you look. Can you tell me what she looks like?"

"A lot like me, but she's got brown eyes like her Da."

"What else? How old is she?"

"Two."

"Just a little girl then."

"Yes, too little to be off on her own. Especially somewhere she doesn't know."

Edith made a mental note to document that, all things considered, it appeared that Margie's maternal instincts remained intact, if not deeply buried. Perhaps with medication and management she wouldn't be a threat to her children after all.

"Let me go ask Dr. Painswick." Edith said, remaining intentionally vague about just _what _she planned to ask her. Margie looked up at her with heavy eyes.

"Please find her," she said quietly, "She needs me."

* * *

"What have you got for me, then?" Elsie said as she walked up to the ER circulation desk. A dark haired man looked up at her slowly.

"They sent her down to your wing."

"Who?"

"The patient."

"The consult I was paged for? I haven't even seen them, how have they already been admitted to my ward?"

The man shrugged, giving her a sly grin. "The attending didn't want to wait. Figured you weren't coming." he narrowed his eyes at her, "The nurses down on your wing seem to think you were _otherwise_ _engaged_."

She glared at him, scanning his scrubs for a badge. "Mr. . ._Barrow_, I'll thank you not to be a gossip. I'm guessing you're new here so let me give you a word of warning: keep your head down and _pick your battles._"

She spun on her heels away from him. As soon as she had exited the ER into the hallway, he smiled smugly, picking up the phone.

"Surgery." Sarah said.

"Well, she finally knows my name."

He could hear her chuckle at the other end of the line. Her voice went low, "Had a run in with her, did ya? Hope you had your sword drawn."

"Nah — think she singed my eyebrows off with her _fire breath_, though."

Sarah chuckled, "So, she's got your number now, does she? Treading a little close to the line, don't you think?"

Thomas sighed, leaning back in his chair. "You know me, O'Brien. I like to live on the edge."

* * *

"Where in the _hell_ have you been?" Beryl said, coming around the corner of the nurses' station. "Why didn't you answer your pages?"

"I didn't hear them," Elsie said flatly. "My pager needs a charge."

"I suppose _you _don't." Beryl scoffed, shoving a chart into Elsie's hands.

"What's that supposed to mean?"

"You were in Dr. Carson's office, I presume."

"Yes, I was." Elsie said, "We were discussing Ruth's case."

"Were you?"

"Yes." she folded her arms across her body and jut out her hip defiantly. "What are you on about?"

"Don't you think you're spending a lot of time in his office, Dr. Hughes? Considering surgery is not your specialty?"

Elsie bit her lip, "He's my colleague — as are you. And for once you're grating my nerves more than he is."

Beryl rolled her eyes. "Whatever you say, Dr. Hughes." she said, pushing past her.

Elsie stood in front of her, blocking her in. "Look Beryl, if you've got something to say, you'd better spit it out."

"I don't give a flying fuck what you do on your own time, Dr. Hughes, but I would appreciate it if you spent a little more time on this _ward_ and a little less time on his—."

"Dr. Hughes!"

Both of them turned toward Anna's voice. The nurse had popped out from one of the patient rooms.

"Dr. Hughes, we really need you in here." she said, her voice faltering.

Elsie turned back to Beryl sharply, her finger nearly touching the nurses' nose.

"You know damn well I've never so much as heard Dr. Carson sneeze. I'll appreciate your keeping me out of your gossip. If you want to make up stories about boffing in on-call rooms I'd think you could find far more attractive and interesting people than _me _to star in them."

She whirled around, her steps skipping as she rounded the corner into the patient's room. There was a woman sitting on the bed holding a baby, and when Elsie came in, the woman's tear streaked face looked up at her anguished.

"This is Gemma Rout and her daughter, Lydia."

"Liddy," Gemma said, "We call her Liddy."

Elsie took a few steps into the room, "Mrs. Rout I'm terribly sorry you've had to wait on me — a communication error, I'm afraid. The attending who admitted you has made a few notes and if you'll just give me a moment to review them—"

"He thinks she has polio."

Elsie looked up, her jaw slack, "Come again?"

Gemma looked up at her, taking a shaky breath. "He said her symptoms are consistent with . . .with polio."

Elsie blinked a few times, then glanced quickly down at Liddy's chart. In the emergency room doctor's hand-scribbled notes, she just barely made out the baby's presentation.

_Patient is a six month old female, febrile 1 week, listless, flaccid paralysis 1 week_ , _won't breastfeed and has not wet a diaper in 48 hours. Mother's pregnancy and postpartum course was normal. The birth was uncomplicated. _

_Only other illness reported by mother was a viral respiratory illness that she and her husband had several weeks ago. No other known exposures. _

_Patient began wheezing this morning, presented to the ER cyanotic and was successfully resuscitated upon arrival. _

_Preliminary radiology reports show what appear to be spinal cord abnormalities that could be early demyelination. Given the lower limb paralysis differential diagnosis includes infectious polio. _

_Have not been able to obtain a pediatric consult, but will admit. _

She lifted her gaze to look at Gemma's. The woman couldn't be more than thirty five, was slight and very pretty — but she looked haggard. Not just new-mum haggard, either. There was something desperately wrong with her child and Elsie had to admit that she may have cost them valuable time in figuring out why.

"Mrs. Rout, would you lay Liddy down on the bed for me, please? I'd like to exam her."

Gemma nodded and turned, lowering Liddy onto the bed. The baby was sleepy, but not in a way that meant she was ready for a nap. The baby's listlessness and heavily lidded eyes, paired with her pallor, made Elsie's breath hitch.

Even though the infant was clearly ill, she was a remarkably pretty baby. Elsie couldn't help but smile as the child's eyes opened up and startled at the sight of the kindly doctor staring down at her.

"She's a beautiful little girl, Mrs. Rout." Elsie said, warming her stethoscope against her hand, "And Lydia is a lovely name."

Gemma shuddered from her nerves, wrapping her hands around her upper arms, feeling useless and afraid. "It's funny, we don't ever call her that. Before she was born we didn't know if she was a boy or a girl so we just referred to the _lump_ as _Little,—_which it wasn't, not for long_. _When she was born we just . . .I don't know, kept calling her that. And it sort of devolved into _Liddle_, then Liddy. Which works, I guess, since her name is Lydia."

Elsie looked up at the young mum whose babbling was nervous, but no less endearing. Over the years Elsie had seen many a mother through a crisis with their children yet she knew she could never truly understand what it must have felt like for them. They always looked up at her, lifting tear streaked faces from their hands, asking "_Do you have children Dr. Hughes?" _

Placing her fingers gently at Liddy's neck, Elsie looked up at Anna, who was standing next to her at the mobile computer unit, ready to take notes.

"Nuchal rigidity — would you put an order in for a spinal tap?"

"A spinal tap – a needle in her spine isn't it?" Gemma said, running a hand nervously across her brow, "Isn't she too little?"

"Babies can have spinal taps safely, Mrs. Rout. And we've one of the best pediatric anesthetists in the entire United Kingdom, I assure you. The reason I want to test her spinal fluid is to rule out certain infections called meningococcal disease — like meningitis, which you've heard of I'm sure."

Gemma nodded, "Do you think she could have that? A school girl died of that a few years ago. I remember it was all over the telly. It happened so fast they just — they just thought she had a flu."

"I would like to rule it out. The doctor who admitted her to the unit has not entirely convinced me that she has polio— but I can't deny that Liddy is not well, Mrs. Rout. She is critically ill at present."

"Will she die?"

Elsie looked down, her eyes trailing the length of her arm to her hand, which was resting gently on Liddy's chest. The baby looked up at her, managing an air of inquisitiveness even through her fatigue.

"I can tell that Liddy is a strong lass — and that her mother is very brave." She reached out and took Gemma's hand. "In my book that makes for a favorable prognosis."

* * *

"A pleasure to see you as always, Cora. I hope you're merely here for a routine physical?"

Richard Clarkson's gentle smile put Cora at ease, but only momentarily. Her leg had started jostling in the waiting room and now that she was sitting atop the examination table, clad in a johnny and chilled to the bone, the nervous jiggling had become a full-on shake that she needed to hold down with the strength of her hand.

"Well, I think — I'll just come out and say it, Dr. Clarkson. I think I'm going through _the change_." she gave him a nervous smile, "Everything seems to be changing lately — physically, I mean — and maybe emotionally too. I'm not sure. I guess you'd have to ask Robert."

Dr. Clarkson chuckled, typing notes into his laptop computer. "I've been a doctor long enough to know I should always trust a woman's instinct. Now, why don't you tell me what's been going on?"

Cora sighed, "Well, just run-of-the-mill menopause stuff, I think. I haven't had my period, but they were a little irregular over the summer so that's not a total surprise. I've been getting dizzy spells. I was sick this morning — and last morning as well. I've not felt like myself for a few weeks. And . . .well, I'm sure it's just that I'm getting older and I can't eat what I want anymore, but I've started to gain a little weight around the middle."

"Do you still have your intrauterine device?" Dr. Clarkson asked, "I see that you would have been due for a new several years back — looks like you had one put in after Sybil was born?"

Cora nodded, "I did, but — well, I figured I didn't really need to get another one put in. I was inching so close to the change I figured we could just use condoms."

"And do you?"

She felt her face flush— she'd known Dr. Clarkson for decades. He'd delivered all three of her girls. Still, talking to him about her sex life felt a bit odd, particularly considering that he played golf with Robert.

"We've been married a very long time, Dr. Clarkson. We've been known to take our chances."

"Have you taken a pregnancy test?"

She laughed at this — louder than she intended, "No — I think I'm a bit past my prime."

"Not necessarily, Cora. I'd like to rule that out before we start testing your hormones for menopause-related activity. I admit, I have to do the pregnancy test anyway before I could prescribe you any estrogen supplements — as a safeguard —so, we might as well get it over with." he spun his chair around and took a sterile cup from the cupboard, then turned back to her, "Can you give a urine sample?"

* * *

"Dr. Hughes?" Anna said, doubling her steps to catch up with the doctor, who had left the nursery just as Dr. Bates had begun the spinal tap on Liddy Rout.

"I'll just be a moment, Anna." Elsie said curtly, "Please stay and assist Dr. Bates."

"Are you alright?" Anna said, quickening her steps enough to put herself, however small, between Elsie and the door to her office. "You've never stepped out on a procedure, especially not one this risky."

"I have full confidence in Dr. Bates—"

"That's not the point," Anna said, a bit more forcefully than she intended. She swallowed her words, breaking Elsie's gaze. "I'm sorry — I just—I know you had a bit of a row with Beryl earlier and —"

"I'm fine, Anna. You needn't worry yourself over it."

"You looked nearly as though you might cry in there, Dr. Hughes. It's not like you..."

Elsie studied the young nurse a moment. Anna Smith had come to Downton as just a nursing intern, fresh from her schooling, and quite frankly had the ideal mix of brains and heart to make a stellar nurse. There was no doubt in Elsie's mind that Anna could easily be running the unit herself in a few short years, unless she decided to marry and have a family. Which, if her relationship with Dr. Bates proved promising, could be an inevitability. Not necessarily a bad one, though: the same qualities that made Anna a wonderful nurse would certainly make her a wonderful mother. Elsie had immediately liked Anna and it had taken her many years to put her finger on exactly what it was about the nurse she liked so much. She hadn't been nearly so sweet when she'd been Anna's age — too jaded and hardened by life's truth before she'd even come of age — so it wasn't that Anna reminded her of herself. More, she'd come to realize, Anna was the daughter she could have had. They didn't particularly look alike — though over the years Elsie was flattered by all Anna had learned from her, not just in protocol and procedure, but even certain things she said to calm a patient, the way she nervously tied up her ponytail with rubber bands and always had her tea milk in first.

And Anna was such a kind soul. If anyone else had chased her out of the ICU she'd have given them a proper dressing down for abandoning their post, going against her orders — but she couldn't bring herself to be angry. Anna wasn't curious, she just cared. And she cared _a lot. _More than she knew what to do with at times, it seemed, which is why Elsie reached a hand out then and did something she'd often thought about doing, but never had: she gently placed a hand against Anna's cheek and smiled.

"Anna, you are a dear sweet girl. One of the best nurses that I have ever had the privilege of working alongside on this unit. I am consistently pleased and proud of your work and I hope that you know you are a valued part of this unit." she lowered her hand and her head, inhaling slowly. "But right now what I need you to do is go assist Dr. Bates."

Anna looked a bit shocked, but there was an acknowledgement in her eyes, pain speaking directly to pain. She nodded and turned on her heels, walking briskly away from Elsie. When the nurse rounded the corner out of view, Elsie turned and threw open the door to her office, closing it quickly behind her as though she were trying to keep something from getting out. Pressing her body against the door, she pressed a hand against her chest and tried to catch her breath. All that caught was the sound of a sob in her throat as she clapped a hand over her mouth.

Then, in the heavy silence of her office, the phone rang. She gently bit the finger that rested against her bottom lip as she contemplated answering it, managing to cross the room and lift the receiver by the fourth ring.

"Dr. Hughes." she said, her voice garbled. She cleared her throat and tried again, "This is Dr. Hughes."

"Are you alright?"

She smiled, reaching up to wipe the dampness from her lashes. Of course it was the only other person at Downton she'd ever imagine asking.

"I've had rather a rough day and it's not even halfway through." she said laughing ruefully, "What about you?"

"Well, I — I found some interesting literature about your case — the young woman you think has the Paroxysmal Nocturnal Haemoglobinuria? I thought perhaps, if you had time, we could get lunch later this afternoon and I'll bring it with me?"

Elsie opened her mouth to accept without a second thought, but Beryl's words from earlier echoed in her ear, bruising her heart further. "Dr. Carson, I —" she swallowed, "I appreciate your research and I do want to view it, but I've got a new admit on the unit— very complex— and I just don't think I'll be able to get away."

"Dinner, then?"

She sighed, her throat aching. "I don't think —" she closed her eyes, her stomach flopping over nervously, "Can you perhaps fax them to my office?"

He didn't speak for a moment and she heard him rustle some papers across his desk, "Yes, yes of course. Dr. Hughes. I didn't mean to impose — um, I'll fax them to your office and you can review at your leisure. I'll let you get back to work."

"Thank you, Dr. Carson."

"You're quite welcome, Dr. Hughes." he said quietly, then a faint _click _as he hung up. Elsie held the phone a moment, pressing it against her shoulder.

Only when she could get the image of him sitting at his desk, staring perplexedly at the papers in his hands, boyish joy fading from his tired face, did she manage to slowly lower the receiver back onto its cradle, the definitive click on her end silenced by the discord of her shaking breath.


	10. Baby's Breath

_**A/N:** Hello my darlings! A new chapter and so sooooon! Sorry we're still in angstville, I promise it'll work out! Don't give up hope! We must always travel in hope, right? I actually wrote this before the last chapter and then had to back up and try to fit it all together. I know it probably feels like there are just so many plots happening right now but is that not the nature of ensemble? Of actual canon Downton?! There's a plan, I promise! Thank you for sticking with me and your reviews and tumblr love. I always get so excited to sit down and see where the story goes! 3_

* * *

"Mum?"

Cora's hand froze above the door handle and she turned. "Oh, hello darling."

Mary took a few steps closer to her, "Are you here to have lunch with Dad?"

"No," Cora said, "I was just — I had a physical."

"Oh. Are you headed to Dad's office now? I was just about to head there myself, I could walk with you."

Cora held her gaze a moment, hoping that her daughter would not notice that her eyes had grown bloodshot as the day had worn on, and there was a deep crease in her brow that was threatening to become a permanent fixture.

"Actually, darling, I have to head back home. I have to take Isis to the groomer this afternoon."

"Oh, well, another time then." Mary said, "Perhaps I'll come for dinner this weekend."

"I hope you will. Sybil will be home from school and I'm sure she'll want to visit with you."

Mary raised an eyebrow, "I suppose she's going to be wandering these halls over her holiday?"

"I wouldn't be so sure. She'd really rather not."

"You can hardly force her. I imagine if you do she'll only cause trouble. And believe me, Downton doesn't need anymore trouble from the Crawley girls."

Cora sighed, putting a hand on Mary's shoulder. "Have you had a chance to speak with Dr. Carson?"

Mary shook her head, "I think I need a bit more time to gather my thoughts."

"Your father said that Isobel's son is on the case now."

Mary hummed non-commitally, busying herself with a hangnail.

"I was just upstairs in Dr. Clarkson's office and she seemed excited that he had decided to take a job here after all. I didn't mention anything about the case but I assume she knows by now."

"She may not," Mary said. "Matthew doesn't strike me as the type to speak just so he can be heard."

"Perhaps when this blows over you two will have a nice working relationship. It would be nice for you to have a few colleagues that you could stand to be around, Mary."

"You'd better go on," Mary said, shaking her head, "You don't want to be late for the groomer. You know it always takes them twice as long to get Isis to settle down." she leaned over and kissed Cora on the cheek and took off through the main doors. Cora watched her eldest daughter striding away, a confidence in how she carried herself so much richer than what Cora had ever possessed. Stepping out into the sunlight and making her way toward the parking lot, the rush of fresh air made her feel infinitely better. The nausea had subsided for the time being and while her heart still beat fiercely in her chest, the warmth of the sun against her skin calmed her. As did the peculiar heaviness in the nest between her hips which all at once became sweet and familiar.

* * *

As the nurses bustled around her, Elsie hovered over Liddy's isolette.

When she'd returned to the room after the spinal tap, Dr. Bates met her in the doorway — his face colorless.

"She went into respiratory arrest," he said. "I got the tap, though. I'll send it off for analysis but it was clear." When she'd pushed past him into the room, Gemma looked up at her, tears streaming down her face.

"Do something!" she screamed.

"Mrs. Rout—" Anna said, putting her arm on Gemma's. She helped her sit down and Anna crossed the room to Elsie. "They've got an isolette set up for her."

"I was only gone for a moment, how could she have decompensated so quickly?" Elsie said, more to herself than Anna.

Now, several hours later, Elsie stood before the isolette in the nursery, watching Liddy's ragged breathing as she slept and asked herself the same question. She thumbed through the pile of literature next to her and even went so far as to pull over one of the mobile computer units so that she could dig even deeper into Liddy's symptomatology.

As far as she was concerned, Liddy did _not_ have polio. But she very well might have something clinically similar. Elsie conjured up a few vague memories of news reports playing in the nurses' station over the summer. American children who had mysterious episodes of paralysis. It had been believed to be linked to a virus in the polio family, and although the literature wasn't solid, it was worth putting in her differential. It took merely a cursory Google search to find the event she recalled.

_Mysterious Virus Paralyzing Children_

Elsie sighed wearily; she detested melodrama and journalists had a way of fear mongering anything medical, particularly where children were concerned. As she probed further, sidestepping the reporting and going straight for the clinical research, Liddy's symptoms suddenly aligned; a constellation in which Elsie would find the answer that could save her.

"_EV68 is one of the more than one hundred types of_ _enteroviruses__, a group of_ _ssRNA_ _viruses containing the_ _polioviruses__,_ _coxsackieviruses__, and_ _echoviruses__.__"_

"_Most of the illness caused by EV-D68 in the US has been respiratory disease, mainly in children."_

"_There have also been some cases of polio-like illness in children in several states associated with EV-D68. In Colorado the virus was isolated from four of 10 children with partial paralysis and limb weakness." *****  
_

"Elsie?"

She looked up. Beryl had materialized next to her, a muffin in each hand.

"I thought you might need something to fortify you." Beryl said, handing one of her treats to Elsie.

She knew it was meant as a peace offering, but Elsie had her reservations. Her mind wasn't in the right place to be talking about the row they'd had — she already felt that she had miles to run in order to catch whatever was making Liddy so ill, and she'd already wasted valuable time.

"Thank you." she said, taking the muffin and admiring it. Beryl was the best cook she'd ever known and a particularly good baker. Elsie was lucky to poach an egg on the second go.

"I'm sorry we had a row earlier. I was only cross because when you're not on the unit to help me wrangle these nurses I lose my damn mind."

Elsie chuckled, pulling the muffin apart into smaller bite-sized pieces. It was lemon, sunflower seeds and ginger — one of her favorites. "I know."

"I'll apologize for being short with you but I _won't_ apologize for insinuating that there's something between you and Dr. Carson."

"Beryl, there's nothing there. I assure you of it."

"It's there, you just don't _see_ it."

Elsie shook her head, popping a bite of muffin into her mouth. "Beryl, stick to nursing and baking. Don't go starting a dating service."

"I don't need to set you up — you're already practically an old married couple, presiding over this hospital like the great Ma and Pa —"

"Please, Beryl. Just drop it."

Sighing heavily, Beryl picked at her muffin, crumbs scattering into her palm. "I don't bring it up to taunt you, Elsie. Really I don't. I just think it would be nice to see you happy is all."

"I _am_ happy."

"Are you?" Beryl said, looking up at her.

Elsie's eyes fell from hers and she let her gaze land on Liddy, who had woken and was staring up at her drowsily. "If I'm unhappy, Beryl, I don't have time to worry about it. The only unhappiness, the only pain, the only _life _that I'm concerned with at this moment is Liddy Rout's."

Beryl nodded, "You're a damn good doctor Elsie Hughes."

Elsie smiled at her as she turned to go, but Beryl paused and turned back after a few steps. She groped around in her scrub's pocket and lifted out an envelope.

"Oh, nearly forgot — this came down with the afternoon's batch of inter-office mail. Looks important. Maybe that audit?"

Brushing crumbs from her hands, Elsie nodded eagerly, taking the letter from her. "Oh, bless you Beryl. Hopefully one thing to scratch off my to-do list."

"Do me a favor and add "tell Daisy to quit calling Beryl '_Nurse Patmore' _to it — makes me feel like I'm in _One Flew Over The _bloody _Cuckoo's Nest!" _

Elsie laughed, sliding her finger into the envelope and ripping it open, "Are you not?"

"Ach!" Beryl groaned, bustling off down the hall.

Sliding her glasses down to perch upon her nose, Elsie lifted the letter from the envelope and was perplexed to see it was on not the letter heading of Robert Crawley, but Dr. Richard Clarkson.

_Elsie, _

_I received the results of your routine mammogram. I have attached the radiology report. _

_Please make an appointment with me ASAP. _

Fumbling to flip to the next page, Elsie's eyes widened as she scanned the report. From the tone of Dr. Clarkson's letter, and the niggling memory of feeling a heaviness in her breast that she couldn't quite account for, she already knew what it would read.

_Highly stratified lesion (4b)* of left breast — suspicious for malignancy. _

_Follow up: biopsy and possible excision of the lesion._

* * *

"Edith, I don't want you to think I'm coming down hard on you to prove a point or sidestep any accusations of nepotism here — but you need to think very, very long and hard about your treatment decisions regarding Margie Drewe."

"I _am_," Edith said meekly, "I think there is insight to be gained here by exploring the delusion. I don't yet know what Marigold represents to her but — but, I think she represents _something_ and whatever that is, it's the key to her breakdown. I'm sure of it."

"I just think you need to exercise a great deal of caution. You don't have the clinical detachment yet. You can't protect yourself from this —"

"I don't need protecting," Edith said, "What do I need protecting from?"

Rosamund sighed, pinching the bridge of her nose. "Edith. You are a sensitive soul. It's one of the things that, no doubt, inclined you to pursue psychiatry. I just worry that combining that with your inexperience, you may not be able to . . ."

"If you think I can't help her than take me off the case." Edith said, rising from her seat.

"I don't want to take you off her case. I just want you to be careful. She's your first delusional case and. . .and it's a compelling case. It involves children. It involves. . .a very nice husband. A husband who himself is very vulnerable right now. You must be mindful, you know as they say, of _folie a deux._"

"_Madness shared by two_," Edith laughed ruefully. "This isn't about me is it? This is about _you._ You sit there and tell me that I lack clinical judgment — that I can't separate myself from the case enough to protect myself — when you're sitting there making this about you. You see me as making the mistakes you made, but I won't. Because I learned from watching you." she threw up her hands, exhaling sharply, "And besides — I'm not married. No prospect of it on the horizon. I don't have anything to lose. There won't be a Marmaduke Painswick to take down with me when _and if _ I go down."

Rosamund's lips came together in a tight line, "You're treading precariously close to the edge here, Edith."

"I'm not going to develop any kind of sordid relationship with my patient's husband." she said, heading for the door, "In the Crawley family lore, _you _laid claim to that trope long ago. I suppose I'll have to find a dishonor all my own."

Rosamund jumped as the door to her office slammed shut, her hand absentmindedly twisting her wedding band, the skin of her finger red where it spun in an endless loop — _till death do us part. _

* * *

"Oh, you're still up."

Cora looked up from the book she'd been reading in bed, or rather, staring at the same passage for the better part of an hour waiting for Robert to get home. As a young wife she'd waited up for him every night; but once the girls came along she was simply too exhausted at the end of the day to hold vigil for him. Once the girls had grown and gone, and she'd struggled to give meaning to her days, more and more she found herself unable to sleep — even long after Robert had finally come home and laid down next to her in their bed.

She smiled, closing the book a little too eagerly. "Hello darling."

Already beginning to loosen his tie before he'd so much as crossed the room to her, he leaned down and kissed her. "I hope you've had a better day than I did. I could use some pleasant news."

Cora blinked, "What's happened?"

Robert sighed, sitting down on the edge of the bed. "I can't make sense of the breach of Dr. Hughes' records. I've had IT scrub through it three times. I'm convinced now that someone has been nosing around under her name but — the thing is, whoever it is, they're _very_ good. It's started to concern me far beyond Dr. Hughes'; unless they have some personal vendetta against _her, _I've got every reason to think they'll strike again — and I have no way of knowing when or where."

"How awful." Cora said, resting her hand on his thigh. He gave her a small shrug, then turned and placed a hand against her cheek.

"What about you, darling? How was your day?"

Her heart pounded in her chest. "Um — well, let's see. I saw Mary today."

"Oh?"

"Yes. She seems to be in better spirits. She may come for dinner this weekend."

"That's great — but where did you see her?"

Cora laughed uneasily, "At the hospital."

"Why were you at the hospital?"

Cora paled, lowering her gaze. "I was in. . .in Dr. Clarkson's office."

"Oh, well you should have come by my office after. We could have had lunch." he said, "Were you there for your physical?"

"No — no, not a physical."

Robert scooted closer to her, resting his hand against her shoulder. "Is everything alright? Are _you _alright?"

Cora gave him a small smile, "I've noticed some things lately. About myself. About my body and — well, I was thinking I might be going through _the change_."

"Oh _God_, Cora. How are we old enough for that?" Robert laughed, "I still look at you and see that twenty-two year old undergrad clutching too many books to her chest as we stood talking in the quad."

"I may be old, but apparently I'm not yet old enough for menopause."

"Oh – well, I suppose that's good? But you're okay, right? Nothing's the matter?"

"Well, not the matter, exactly." Cora sighed, "Have you noticed anything different about me lately? Physically or — emotionally, maybe?"

Robert shrugged, "No — well, maybe you've been a little weepier than usual. Remember last weekend when we watched that movie? George Clooney in space?" he chuckled, "You were _really _blubbering."

"It was _sad_, Robert!" she said, smacking his arm. "Have you noticed anything _physically _different?"

"I feel like this is a trap, darling. Like when you ask me if a dress makes you look fat and of course it _never_ does, but if I tell you that you'll think I'm lying—"

"Oh, Robert!" she huffed, throwing the covers back and standing up beside the bed. She lifted her night shirt, exposing her bare middle. "_Look_."

"What— what am I looking at?" Robert stuttered.

"This _tummy _I've got — it's _not _middle aged spread. It's _not _toast," she laughed, her eyes starting to water. "Robert. I'm _pregnant._"

Robert held her gaze a moment, then he let his gaze fall to her middle. "_Pregnant?_ How did this happen?"

Letting her shirt fall back over her middle, Cora threw her hands up exasperatedly, "_Oh, I don't know_ — might have had something to do with the sex we've been having?"

"No — no, I mean— how did — Cora, you haven't been pregnant for eighteen years!"

"You're a doctor, Robert – you tell me!"

There was a moment of uncomfortable silence as she sat down next to him on the bed. Then, she turned toward him, "Are you mad?"

"Mad? Cora, no. I'm not mad. I'm just — I'm shocked that's all." he pressed his hands against his face, a boyish grin spreading across his face. "You're really pregnant?"

She nodded, "12 weeks* — can you believe that? I'm already practically done with the first trimester."

"Oh my God. . ." Robert said, taking his hands from his face and placing them against hers. "A baby — at our age!"

Cora laughed, tears falling onto her cheeks. Robert wiped them away with his thumb, then kissed her softly. When he pulled away, she pressed her forehead to his. "And who knows — maybe we'll get a _boy_ this time!"

* * *

"I thought I might find you here."

Elsie looked up to where he stood, leaning against the doorway to the nursery. Even though he was whispering, the low rumble of his voice carried across the room and made Liddy stir in her arms.

"It's very late, Dr. Carson." she whispered, rocking the baby gently. "I would have thought you'd gone home hours ago."

He shrugged, stepping into the room and taking a seat near her in one of the many rocking chairs scattered about the room. "Well, I will be shortly. I just wanted to see if you were alright."

She flicked her gaze up at him, "That's kind of you."

"So, this is your new admit?" he looked down at the baby in her arms, who had fallen back into a fitful sleep.

Elsie sighed, "I think it's Enterovirus D68. I've been reviewing the literature all evening and there was a cluster of cases in America — many of which led to acute flaccid myelitis. Of course it's too soon to know if it will be permanent. For many of the American children it was, so, until I can confirm the presence of the virus I'm going to assume as much. She's stable for now. I made her mother up a cot and she's sleeping, finally. Poor dear. But she's very brave. And this little girl is very strong."

"I'm quite impressed with your diagnosis. Not that I wouldn't have expected you to be up on your literature but – even still. I must say you never cease to amaze me, Dr. Hughes."

She gave him a small smile. Liddy cooed in her arms, punching her tiny fists against the air. Elsie reached her finger down, pressing it into the infant's hand. Fingers clasped tightly round it, the baby gave a deep sigh and fell back into her slumber. Elsie giggled, seeming to forget that Dr. Carson was even in the room.

"_Oh my_! What a mighty sigh for such a _wee_ bairn," she hushed, lifting the baby up against her shoulder, rubbing her back soothingly. She looked over her swaddled shoulder at Dr. Carson, who was looking at her peculiarly.

"You're kind to say so but I'm only doing my job." she pressed her cheek against the baby's head, letting her eyes close for a moment. When she opened them, he was still looking at her, his bottom lip trembling nervously, as though he had words to say but required her permission. "You've something on your mind, Dr. Carson?"

He broke her gaze, looking down at his hands. He turned them over in his lap a few times, then pressed them together, scratching the top of his knuckles absent mindedly. "I suppose it's always a little strange to see you with the children."

She narrowed her gaze, "How so, Dr. Carson? I'm a pediatrician; wouldn't it be far stranger if you _never _saw me with a child?"

He laughed, "Yes, that's true. Even after all these years I marvel at what a natural you are. Considering you never. . ." he shook his head, dismissing the thought, "No. I won't."

"Well, now you've piqued my curiosity." she said, "It's late, go on then. At our age, come tomorrow, we'll likely forget we've spoken anyhow."

_I could never forget our conversations, _he thought, tilting his head a bit to look at her. In the dim light of the nursery, the least harsh lighting in the hospital as it were, she looked very calm. She held her face in a tired, but calm, repose. The soft lilt of her voice as she spoke to the baby, to him, thick with sleepiness and shadows of her Scottish roots. As he caught her eye, she tugged at her bottom lip, her eyebrows raising the question.

"I suppose I just wonder if you would have liked to have had children of your own, Dr. Hughes."

If she was startled by his inquiry, it didn't show. She lowered Liddy back into her arms, adjusting the swaddling around her and studying the baby's face a moment before she spoke.

"I've never known you to be sentimental, Dr. Carson." she said without looking up, "Though, I've occasionally wondered the same of you."

"Wondered if I'd have wanted to raise a family?"

She shrugged, "Well, _marry_ at least. Maybe longed for something other than Downton."

_Only you, _he thought, his heart beginning to race.

Elsie sighed, "When I first started my residency I suppose I thought about it. Many of the women I went to medical school with went on to have fine marriages, a few children — though, none of them are Chief of their department to my knowledge. I suppose I made a choice, as they did. I don't think I chose better, or more wisely — just differently."

"Must you have chosen at all?"

She did look up at him then, "A woman _always_ has to choose, Dr. Carson. Deep down I suspect that had I been trying to balance my work here with raising children of my own, I may not have had the energy, or the heart, to care for all my—" she gave him a mischievous grin, "_little darlings._"

"In any case, no matter what choice you made, I'm sure you would have excelled in that life as much as you have in this one," he offered, his cheeks pinking.

"You're full of praise for me this evening, Dr. Carson. I'm beginning to worry you're working up to some wretched announcement." her face fell, "Please don't tell me you're _retiring_!"

"Oh, no no!" he said, a bit too loudly. Liddy squirmed in Elsie's arms, blinking awake. "Damn, I've woken her —" he said, rising to leave.

"Stay," she said, "Why don't you hold her for a moment – I've got to get up and grab one of the infant cuffs so that I can take her blood pressure anyhow."

He lowered himself slowly back into the chair, lifting his arms to accept the tiny bundle from her. Liddy, with her large, inquisitive eyes, stared up at him with an incredulous affection; a look that he was used to getting from a certain Scottish physician, but never a baby.

"She's fond of you." Elsie said from across the room, "See? She quieted right down." Walking over to the chair, blood pressure cuff in hand, she knelt down next to him. As she wriggled one of the baby's arms from the swaddling, she flicked her eyes up to watch Dr. Carson's face. He had a look of astonishment and apprehension. A fatherly look if there ever was one.

"What about you, then?" she said, "Ever wanted _a little Carson_ all your own?"

He faltered, "Well — I don't know, I suppose if — if I'd met the right person." he swallowed hard. He could have sworn that Liddy raised a tiny eyebrow at him.

"Preferably a woman who wouldn't have been opposed to you reading bedtime stories from The Merck Manual*****?" she teased, her arm inadvertently pressing against his thigh as she took Liddy's blood pressure. Even through his trousers he could feel how warm she was next to him. It was deeply pleasant and he felt a small smile tugging at his lips.

"In an ideal world she'd have been at my side with a coloring book of anatomical illustrations."

Elsie chuckled, releasing Liddy's arm from the cuff and tucking it tenderly back amongst the blankets. She pressed the tip of her finger to the baby's nose as she stood, crossing in front of him and settling back into her own rocking chair. He lifted his arms uncertainly, trying to gauge if she wanted the baby passed back to her, but she waved her hand dismissively.

"She's content for now and I've got to chart her vitals. Unless you've got somewhere to be?"

He smiled, settling back against the chair. _Nowhere I'd rather be, _he thought.

"If I didn't know better I'd say you were almost enjoying this moment, Dr. Carson." Elsie said, tossing her hair back from her face so that she could put on her glasses. She gave him a knowing grin and turned to Liddy's chart. For a moment, the only sound in the nursery was the flow of her elegant script across the paper and Liddy's tiny rasps.

"Truth be told, I could _never_ have had a child of my own in good conscious." he chuckled, "Imagine a baby as small as this one— _with a nose like mine_!"

She offered him a small laugh at the self deprecation, leaning back and removing her glasses.

"_Mine _probably would have had a thick brogue before their first birthday and hell-fire red hair."

"You don't have red hair." he said, raising his eyebrows playfully at Liddy, who offered him a weak smile. Elsie chuckled, suddenly realizing how exhausted she was. Rubbing the sleep from her eyes, she thought, _I don't, but Becky does._

He blinked a few times, his brow furrowing. "Who's that?"

"Hm?" she said, yawning widely.

"Who's Becky?"

Her breath hitched and he saw, in that moment, her entire demeanor shift. Even the air in the room suddenly felt oppressive, like suffocating in a smoke-filled house. Her eyes widened fearfully, and after a few moments they glistened with unshed tears.

She'd never meant to say it out loud.

"I'm sorry —" he said, "You just — you said "_Becky does_,"—has red hair, I mean—"

He studied her a moment but he couldn't figure out what her look meant. Was she in the throes of concocting a lie? Struggling to reveal some terrible truth to him? He felt his stomach drop and he wondered if he'd hurt her. Whatever she'd said was clearly never intended to be verbalized. He was only relieved that if it _was_ some awful secret of hers, there was no one else around to hear it. She could count on him to keep it — and certainly Liddy wouldn't be a worry. She was preverbal.

In the heavy moments that followed, Elsie too reverted to a preverbal state. She hemmed and hawed, trying to make her mouth form words.

"You don't have to say," he said finally, standing and leaning over her, gently lowering Liddy into her arms, "I should be getting home."

He turned to leave and heard her voice, aching from across the room, just as he reached for the door knob.

"My sister," she said. "Becky is my sister." He turned slowly, his mouth drying out.

He inhaled deeply, suddenly nervous for her somehow. "I thought you didn't have any family left?"

He was just far enough away that he couldn't be sure that she had begun to cry, but as she spoke again, he became certain that at the very least she was teetering on the edge of a long overdue sob.

She looked down at Liddy, letting her hand rest against her head, wisps of soft hair against her palm. In that moment, feeling the weight of her failures — with Becky, with her patients, with _him, _she felt a pain so deep in her heart, so prolific in its presence, that she wondered if _that's _what the radiologist saw in her breath; not a cancer, but a wound. Not of her breast, but her heart. He hovered in the doorway, clearly not sure if he should leave her or step back in. She knew he was waiting for her to speak, but she wasn't sure what to say.

So, as she lifted her face to him, she settled for the truth.

"Probably because that's what I _wanted _you to think."

* * *

* E68, which we still don't know all that much about. I'll be taking a bit of literary license here because, frankly, the research is quite new even if the actual virus itself was discovered decades ago. The link to the paralysis is what's relatively new.

* BI-RAD (Breast Imagining Reporting and Data System) is what radiologists use to assess breast ultrasounds and mammograms. So, it's staged in various categories from like, benign to confirmed malignancy. 4B is a sub rating of 'suspicious abnormalities' seen by a radiologist that is not confirmed malignancy, but probably warrants either a biopsy or excision — or both. 4A, 4B and 4C are various levels of probability of malignancy, 4B being intermediate.

* Particularly since Cora is quite tall (well, because Elizabeth McGovern is, haha) and she wasn't even considering that she could be pregnant, it's entirely probable that she wouldn't be showing as much as other women might by the end of the first trimester. Though, after having three pregnancies she's probably showing enough to notice _something, _if not a totally obvious bump. It's always different for every woman, and even different for each pregnancy in the _same _woman, but just know that I didn't choose the week arbitrarily ;)

* The Merck Manual is like, the medical Bible. It's a big ol' textbook of symptoms, conditions, diseases, injuries. . .everything. Mine is on my nightstand!


	11. Wide Awake

**A/N: Just a warning, this chapter might be triggering for some: there's reference to past abuse, as well as the 7/7 Bombings in London.**

* * *

Against his better judgment, Charles continued to hover in the doorway. He wanted to go to her, then. Sit in the rocker across from her, listen intently to whatever she was so desperate to unburden— but he couldn't seem to lift his feet from the floor. She looked so frightened, so incredibly vulnerable in that moment. He was afraid if he moved too quickly, he'd only spook her.

"You've had a very trying day, Dr. Hughes." he said evenly. "No doubt your fatigue has betrayed your heart. If you would prefer it, I will just head home and we can pretend this never happened."

She smiled. Even from across the room he could see the dampness of her cheek. A few tears had been shed; indeed, a few too many as far as she was concerned.

"Thank you for that, Dr. Carson." she said, "I've gone this many years without anyone catching on and it would be a shame to break the record now."

He nodded. "I just want to go _on record_ as saying — that—" he cleared his throat, "That I would _not_ tell anyone and — I suppose what I'm trying to say is — if you _wanted_ to tell me. Or, if you didn't want me to _forget_ what you've already told me. Or if there's more you'd like to say — you could rest assured that it would be safely kept with me. I don't want you to feel as though you must lie to me—"

"I don't _lie,_ Dr. Carson. But there _are _things that I don't say." she said quietly. "Even still, I don't deserve your kindness."

"Dr. Hughes you've carried this burden for a very long time. I have nothing but kindness for you."

She sighed, "My sister — Becky — she's in a facility in Lytham Saint Annes."

_There it is,_ he thought, _an invitation to come back in_. Cautiously, he stepped into the nursery again, hovering above the rocking chair he'd only moments ago vacated before lowering himself back into it. She didn't flinch.

"She's — _ah _— well, she was born a bit . . ._unsteady._ Mentally, I mean. When my mother died, I had a semester left of medical school and — well. . ."

"Becky's care fell to _you_."

"Yes."

"And you would have had to give up everything to care for her."

"I couldn't have been her caretaker _and_ worked — and I _had_ to work. My family had no money. I was the first in my family to go to university and I suppose — I'd come _so_ far. I was going to be a _doctor _in a few short months and — well, I knew I could never look after her properly working a doctor's shifts. Especially as an intern. I couldn't have been there for her. I couldn't be the person she needed me to be so — so I paid someone else to."

"That must cost you a fortune."

"It has. I knew all too well that sending her to a state-funded facility wouldn't have been good for her. I've paid dearly for her to have private care. And in Lytham Saint Annes, so she can be close to the sea. They take very good care of her but —" she shook her head sadly, "I'll never be able to stop working, Dr. Carson. I don't know what will happen if I can no longer work."

"Surely you've saved, made some investments? Or at least your retirement?"

She swallowed hard, "Unfortunately, no. I was going along quite well for a while but — well, a few years ago the costs went up. More than the NHS would provide and — well, I had to dip into my retirement. There's not much left and I've no time to build it up again."

"I see."

Liddy began to stir in Elsie's arms and she hushed her, rocking her gently. Charles felt his heart clench and his hand began to pump into a fist with nervous tension as he realized the truth.

"You never _had _a choice."

She looked up at him, petting Liddy's head gently. " I don't know what you mean."

"You devoted your life to Becky's care when you were still a young woman. You put her needs and wants ahead of your own. You were tasked with raising her — you _couldn't_ have had your own children, even if you wanted them _desperately_—"

"I will detest it if you pity me, Dr. Carson—" she warned, locking eyes with him.

"I don't, Dr. Hughes. I assure you I don't. I'm only trying to understand. We've been colleagues all these years and I realize now — I don't really _know_ you."

"There isn't much _to_ know." she said curtly.

"It must have been difficult to do all of that on your own. I've always known you to possess true grit, Elsie Hughes, but I never knew just how deeply it ran."

The way he said her name — _a low, sweet rumble_ — it was almost as though, as she looked at him then, he did not look quite himself. Or, at least, not the man she'd known all these years, saved lives alongside of, shared coffee with.

"I knew when I was twenty-four years old that I would never marry or have any bairns of my own, Dr. Carson. I've devoted my life to Becky, and to these children." She ran a finger along Liddy's cheek, "Whether or not the choice was mine, I never would have brought anyone else into it. I never would have burdened anyone else."

_I wish you'd told me back then, at least let me be a confidant, _he thought. Just as he plucked up some midnight courage and opened his mouth to speak, Elsie jolted in the chair across from him; the only abrupt movement that had been made in hours.

"She's seizing." she said, standing up and taking Liddy to one of the tables in the far corner of the room. He stood and raced to her side, opening up one of the cabinets and scanning for a syringe.

"You're alright, love." Elsie cooed, preparing a neonatal cannula to help the baby breath. She looked up at him helplessly and saw him moving toward her. He reached for Liddy's IV shunt and Elsie stopped him. "Phenobarbital?"

He nodded, "15 mg pediatric loading dose," he steadied the syringe, "Am I right?"

"Yes," she breathed, her eyes wide.

"I've learned a thing or two from you over the years," he said, gently depressing the syringe.

"She must be encephalitic." Elsie said, turning back to Liddy.

"From the virus?"

"I can't say for certain."

Liddy's movements began to calm, and Charles exhaled deeply. "Should I prepare another 5mg?"

The baby settled into painful exhaustion, beginning to whimper. "No — not yet." Elsie carefully re-swaddled her and gently attempted to place the cannula against the baby's tiny nose.

"Are you alright?" he said, "Your hand is shaking..." He reached over without thinking, steadying her fingers and helping to guide the tiny tubes into the baby's nose. She pulled her hand back sharply, taking a step away from him.

"Her mother is in the south on-call room, on a spare cot. Would you go wake her, please?"

"Yes," he said, suddenly quite flustered. He looked at her a moment; her face red and blotchy, eyes heavy and seeking sleep. Her lips were dry and cracked, and she had pulled the bottom one under her front teeth, her tongue darting out to sooth a bleeding split.

He wanted desperately to take her into his arms, to encircle her and bring his lips to hers.

Instead, he turned on his heels and left her there; one hand stroking the head of a baby that wasn't hers and the other reaching up to touch her bloodied, tender lip.

* * *

Laying his head against Cora's bare chest, Robert laughed through his ragged breath.

"You know — I think I _have _noticed something different—" he said, trying to catch his breath. He reached a hand up and cupped her breast gently, "_These._"

Cora laughed, pressing her hand against the back of his head. "Robert!"

"I didn't notice it until you pointed it out but —" he reached a hand down to rest against her middle, which was warm, still rising and falling from their romp "You _do _have a bit of a tum, don't you?"

"How reassuring to know that if I _was_ just chubby you wouldn't have noticed or cared."

"Not in the least!" he said, picking his head up to kiss her resolutely. She laughed, licking the sweat from her top lip. He settled his head against her, a bit lower down, and wrapped his arms underneath her, hugging her tight. They sighed contentedly.

After a moment, he was startled by laughter rattling away in her chest.

"What?" he said, giving her a sleepy grin.

"How are we going to tell the girls?"

"Oh. _Oh._" he said sitting up, running his fingers through his hair. "They won't believe it."

"Maybe we ought to wait."

"Until —?"

"I have an ultrasound appointment on Friday, before Sybil gets home. Shouldn't we wait to tell anyone until we've seen it? Heard the heartbeat?"

"I suppose." he scooted up next to her in the bed, leaning his head on her shoulder, his back against the headboard, "What are we going to tell my _mother?" _

Cora let her head loll to the side, resting atop his. "Do you remember what she said when we told her I was pregnant with Mary?"

"_Cora, dear_." Robert said, his impression of his mother unsettling in its accuracy, "_Crawley women aren't "pregnant" _— _they're expecting._"

"Well, we can hardly say that this time." Cora laughed, "We certainly weren't _expecting _this!"

* * *

Anna hadn't realized how many consecutive nights she'd slept in an on-call room until she finally staggered home to her flat and saw the mess of dishes and clothes she'd left behind. Too exhausted from her shift, she told herself she'd deal with it tomorrow — which happened to be her first day off in a fortnight. Other than sleeping and _laundry, _she didn't have much in mind. She always felt a bit out of place anywhere except Downton. She understood that world, understood the order of things — understood the people. Left alone, in the deafening silence of her bedroom, she had a tendency to think too much. _To feel too much. _

She didn't mind being alone, except at night. Something about the darkness, the quiet, lent itself to brushing the dirt off memories she'd thought she'd buried. Nightmares of hands coming at her face fast and hard, pressing her body against a wall, shielding her face with her arms. The bruises, the cigarette burns — the scars she wore and those that wore her out.

Stripping off her scrubs and leaving them to wrinkle, she climbed into bed, the cool sheets against her skin chilling her. She hugged her pillow against herself and tried to push the memories from her mind, thinking instead of the very long day she'd had. She often liked to take stock of her actions from the previous day as she fell asleep at night. Assigning herself a social grade according to how well she'd functioned, what she'd managed to achieve. Perhaps she'd made a sick child laugh, forgetting their illness for a moment. Maybe she'd comforted a parent — or colleague.

Today — or rather, as she looked at the clock as the reading changed to 12:35 pm, _yesterday, _she had managed to do quite a few of those things. Her heart was heavy in her chest, beating slowly as the rest of her contemplated sleep. She'd be far too afraid to admit it aloud, or even fully accept it within herself, but she had always looked to Dr. Hughes as a bit of a maternal figure. Seeing her upended and emotionally wrought gave her an unsettled feeling. Generally speaking, if Dr. Hughes was rattled, it could be assumed everyone else ought to be as well. Nothing ever managed to shake her and for many, not just Anna, she was a totem.

Whatever had upset her, she had politely put up a barrier to Anna's empathy. Though she'd expected as much, it was difficult to be rejected (no matter how nicely) when she'd only wanted to help. Dr. Hughes calmed everyone — nurses, patients, parents — exceptionally well, but in all the years Anna had worked alongside her she'd never seen anyone comfort _her_.

She rolled over, sighing into her pillow, thinking then of John. She wished she'd just stayed at the hospital, slept in an on-call room with him again. She hadn't dared after being caught out by Phyllis. They'd been lucky it'd been her; the kindly nurse would be far too humiliated to ever mention it to anyone, but clearly the pair had become lazy. Too comfortable in their little . . .well, whatever it was. She hadn't quite dared call it a relationship but it certainly was more than a friendship now. As it had been for several weeks now, his was the last face she saw before she finally, blissfully, drifted off to sleep.

* * *

Rosamund Painswick kept all her secrets stowed neatly away in a tattered shoebox on the top shelf of her closet. She had lay awake in her bed for hours, hearing it calling out to her. No rest would come until she went to it, lifted the lid and let out the ghosts.

Padding barefoot across her bedroom in the dark, pulling her robe tightly round her middle, she fumbled for the chain of the overhead light in her small closet. As it flickered on, she narrowed her gaze, the burst of yellow making her eyes ache. She pretended, for a moment, that she didn't know precisely where the box was hiding, beneath spare sheets and pillowcases, behind the iron and a pair of mules she'd never worn. She wanted to believe that maybe she wouldn't find it. Have no choice but to go back to bed without feeling the familiar, flaky cardboard.

But it was there. Right where she knew it would be.

She sighed, reaching up to lift it from the spot where it lived and tucked it under her arm as she crossed the room back to her bed. Sitting down, she set it atop her comforter and carefully opened it, her fingers coated with gray dust.

His face looked back at her in a faded photograph the color of late autumn, a water stain at the edge and one torn-off corner. She picked it up, bringing it to her face, examining him in the low light from her closet. His eyes had always been so deeply kind, especially when he looked at _her. _He was a good man, a fine husband. He would have been a wonderful father.

The next photo in the box was the last one taken of them together. The annual hospital gala, which was always the Friday before Christmas. It had been a miserably cold night and her stockings did little to keep her legs warm. He'd made her laugh, furiously rubbing his hands up and down her calves, trying to warm them, as they sped through London in the back of a town car. She'd pressed against him to shield herself from the cold wind as they climbed the front steps of the hospital's academic center; the most beautiful, and oldest, building on campus.

In the photograph, their cheeks were red from the cold and he had his arms wrapped tightly round her waist, pulling her close. Her head was thrown back in laughter, and his wide smile to the camera gave him crow's feet. She couldn't remember who had taken it — but she'd have liked to shake their hand. If only it could have stopped with that night; if that moment could have been their last, if it must have been. _Why, why, why _did the weeks that followed have to exist at all?

The folded newspaper clipping felt gritty against her fingertips as she unfolded it.

**_Al-Qa'eda Brings Terror to The Heart of London_**

Then, behind it, the single strand of newsprint topped with his name:

_Marmaduke Painswick, 45, was one of the fifty-two civilians killed in the bombings of central London. Mr. Painswick was crossing Tavistock Square, as he did each morning on his way to work, according to his wife of twenty years, Rosamund. _

"_He was a litigator at Painswick and Cross. He handled mostly malpractice suits." she told The Guardian, "He was on his way to the office of the British Medical Association, which is on Upper Woburn Place." _

_For those on the bus where the fourth bomb of 7/7 detonated, as well as those who happened to step into its path, the location of the BMA was of vital importance. Doctors and nurses inside the offices who heard or saw the blast were able to provide immediate medical care to many victims. Thirteen perished in Tavistock Square that day. Marmaduke Painswick died trying to save them._

"_Witnesses told investigators that he had just crossed the road and — and heard the blast. He turned round and ran back to the bus and started trying to pull people from the wreck. I don't know how many he saved. I know there was a child who remembered him being there. When the back-end of the bus collapsed, he was under it. I don't know if he died instantly. I suppose I hope he did." his wife says, "I know it's terrible to think it but . . .part of me wishes he hadn't tried to help. If he'd not gone back, he'd still be here. But that was the kind of man he was. He couldn't have just stood there and watched helplessly." _

She reached up to wipe the tears from her eyes, pressing the clippings to her chest and letting her head lower. When she dropped them back into the box, along with the photographs, she dug through a few more clippings until she found an envelope. Lifting it out, her fingers twitching against the thick card stock, she pulled the letter from its papery casing.

_R,_

_We could leave London; I could take you to my summer home in Genoa. Or anywhere in the world. We could start again. You can divorce Marmaduke, or just leave him — just please, come with me. Consider it at least. You could leave London, leave Downton — Ros, you could have a life all your own, a practice of your own if that's what you want. You don't have to settle for what Downton is giving you — we both know you can give more, that you deserve more.  
_

_Promise me you'll think about it. _

_Yours always,_

_J_

She threw the letter back into the box, pressing the cover tightly back onto it, depressing the flimsy cardboard, and stared at it only a moment before she picked the whole mess up and cast it hard across the room, the sound of her shame hitting the wall, the leafing of papers scattering down to the floor, masked by the sound of her anguished scream against her hands.


	12. Pulse

Mary hovered outside Dr. Carson's door. She checked her watch; 7:57 am.

She was three minutes early.

Since her intern days, his office had been a safe place for her. Somewhere she could go and not be judged for asking questions. Somewhere she could go when she _couldn't _knock on her father's door — or, quite simply, when she would rather not have.

Dr. Carson had been more than just a mentor. She'd known him since she was a little girl, running around the hospital with her father who was ever proud to show off his eldest daughter. While much of Downton's staff found her incessant questioning distracting and, _she could only assume_, obnoxious, Dr. Carson had embraced her immediately. He found her precocity endearing, her tough little spirit delightful. Mary's father had said, _Ah, old Carson. Never married or had any of his own — but that means you ought to feel extra special Mary. He's chosen to bestow his wisdom upon __you._

She _had_ felt special. When she was just sixteen he had allowed her to observe her first surgery. She could remember it vividly; repair of an aortic dissection. She'd stood shaking in the freezing operating suite, the scrubs a size too big and hanging awkwardly from her tall, lithe frame. The scrub nurses pushed her over next to the operating table, _touch nothing or we'll boot you right out, _they warned, _if you so much as think about touching the corner of that table we've got to re-sterilize everything!* _She'd kept her hands pressed closed to her sides, her breath hot against her cheeks inside the surgical mask. Even though she couldn't see Dr. Carson's mouth behind his, the smile in his eyes relaxed her.

"_I hope you've already had your tea," he said, "This is likely to take up the rest of your afternoon." _

"_I was just restocking the bandages in the ER," she said, "I doubt they'll miss me." _

_He glanced at the clock on the wall, "If we're lucky we'll be done by — perhaps, seven o'clock?" _

_Mary swallowed. It was just after eleven in the morning. _

"_The patient is a forty-five year old male with no prior cardiac history who presented to the emergency department with sudden onset severe chest pain, diaphoresis, nausea and neurological deficit upon further exam. An MI was ruled out but the unfortunate chap does appear to be gravely ill." he paused dramatically, "What is your medical opinion Miss. Crawley?" _

_Without hesitation she spoke up, "Type A aortic dissection." _

"_Very good. Management?" _

"_Surgical — ah, repair of the dissection and — uh, well if the aorta needs to be replaced entirely he'll need a prosthetic valve." _

"_Sounds good to me. Now, what is my first incision?" _

_She hesitated, "A — um. . .median sternotomy?" _

_Dr. Carson smiled, "Nurse — the ultrasonic scalpel if you would. And prep the pneumatic sternal saw." _

_Mary watched in awe as Dr. Carson's hands moved swiftly across the man's chest, the scalpel confidently, yet gently, cutting a deep line down the middle. _

"_I know this is your first surgery, and it's rather a doozy if I do say so myself, but I have full confidence in you Mary." Dr. Carson said, passing the scalpel across the man's body to the scrub nurse, "That being said, there's no shame in fainting. I only ask that if you must, you position yourself on that far wall, your back pressed firmly against it — that way if you faint you'll slink rather quietly to the floor without disrupting any of the instrument trays*." _

_Mary nodded, "I'll be fine, Dr. Carson. Now," she clapped her gloved hands together, "when will the anesthetist be starting the cardioplegic solution?" _

_The nurse raised her eyebrows incredulously, but Carson only laughed, the sound of the saw whirring to life making him lift his voice, "I see you've been reading the texts I lent you." _

"_Yes," Mary said, pushing her voice over the saw and the barrier of her mask, "From cover to cover." _

"_Remind us all why we use the solution?" _

"_To still the heart while the sutures are made." _

"_Because?" _

"_Because — well, you can't repair a heart that's still beating." _

_Dr. Carson chuckled, "Which is precisely why, my dear girl, broken hearts can never heal completely." _

Standing outside his door now, she felt her own heart beating so heavily against her sternum that she thought she might do well to inject the solution into it herself. She checked her watch again — 8 am on the nose. Sighing deeply, she rapped on his door.

"Yes— come in."

She pushed it open, with a bit more force than was required, and felt her toes push against the front of her shoes, keeping her from falling forward.

"Have a seat, Dr. Crawley." Carson said.

There was a moment of almost painful silence between them as she settled into the chair. It used to be that they would have a witty exchange — pleasantries at the very _least._ He looked up at her, closing the file he'd been looking at when she came in, and folded his hands atop it.

"You'll be pleased to know that Dr. Crawley — _Matthew,_ that is, — has reported your heart transplant patient is stable and his prognosis good."

"That_'_s good news," Mary said. "It seems that Matthew has adjusted well to how we do things here."

"He did not back down from a challenge, I'll give him that." Carson said, "But we're not here to review his performance. We're here to talk about _yours." _

Mary said nothing, only folded her hands neatly in her lap.

"The pathology report from the donor heart, when compared to the sample from the patient's heart, leads me to believe antibody-mediated rejection caused Mr. Mason's deterioration, rather than acute cell-mediated rejection."

"I would agree. There was endothelial cell swelling."

"You've read the mortality statistics for AMR?"

"Yes."

"I assume that's influenced your prognosis for Mr. Mason?"

"Yes —though I think his age is on his side."

"You understand that the preoperative testing was incomplete."

Mary stiffened, "It was _not, _Dr. Carson. With all due respect, I would ask that you review the patient's electronic medical record."

"I have reviewed it _thoroughly_ Dr. Crawley."

"I stand by my assertion that the preoperative lab studies _were_ drawn, the same as in any transplant case. If you are unable to review them in the patient's record I have no answer for that, but I can tell you that I would _not_ have performed the transplant without them." she paused, exhaling deeply, "I learned from _you,_ Dr. Carson."

His exterior softened. "That's true, Dr. Crawley. I suppose that's why I feel so deeply affected."

"Dr. Carson, you can never hold yourself accountable for my mistakes. _If and when _I make them."

She gave him a sly smile — and to her relief, he smiled back, shaking his head lightly.

"We all do, my dear. And sometimes the mistakes of the heart are _not_ made in the operating theatre."

Mary furrowed her brow, "Dr. Carson — it's not like you to be so mawkish."

"The older you get, Dr. Crawley, the more saccharine your thoughts become. It's a widely reported symptom of aging. One, to which, I am apparently not immune."

Mary tilted her head, regarding him affectionately. "Well now, Dr. Carson — would you really want to be?"

They exchanged a glance and both knew to whom his musings referred. They'd not spoken of it, and neither would broach the topic. After a moment, Dr. Carson lifted the patient's chart from his desk and passed it across his desk to her.

"You'll consult for — _erm _— the _other _Dr. Crawley."

* * *

"Oh for _pity's sake_, don't tell me you slept here all night!"

Elsie startled, having nodded off apparently, despite sitting upright at her desk. If Beryl had knocked, she'd not heard her; though it was equally as likely she'd simply barged in on her own accord.

"Where's your coffee?" Beryl said, closing the door behind her. "I'd have brought you a cup but, you know, usually you get it _delivered_."

Elsie blinked, her eyes still heavy with sleep. "I — well, I've been working."

"I'd say you have been," Beryl laughed, plopping down in her usual chair. "Did you sleep at all?"

"Not really. I was in the nursery — Liddy seized last night. Imaging showed she is, indeed, encephalitic but I have yet to confirm it's enterovirus."

"Poor little thing." Beryl said, "Guess it was good you were there. But who was on call?"

"It was just me and —" she hesitated, "Well, Dr. Carson had stopped by and —"

"Oh, _I see_."

"I was lucky he was there. He was able to prep the phenobarbital and we stabilized her." Elsie furrowed her brow, "Though he's_ quite_ an odd duck if you catch him at the late hour."

"Oh?" Beryl said—a woman primed for a smidgen of gossip if there ever was one.

"Well, I was holding Liddy, just soothing her—she's in quite a lot of pain and I wanted to keep her blood pressure down— and, well, I'd asked him the other morning, off the cuff you know, if he'd ever wished he'd settled down, had a family —"

"You _did_?"

"Well, I was feeling a bit low — was more about putting my own regrets at ease than wondering about _his, _I admit — but then, last night, well . . .we had a particularly deep conversation about those choices and —" she hesitated, "some of the obstacles, the justifications for those choices — and he said that he'd have _liked_ to be married, had children, had he found the right woman. I don't know, I just —" she looked down, suddenly feeling a bit shy. "I couldn't for the life of me figure out why he cared so much about what _I_ felt about it."

Beryl laughed, slapping her hand against the hard oak of Elsie's desk. "Ha! You're kidding." Elsie looked at her startled. Beryl's mouth hung open, "Oh, — _sweet baby Jesus, _you —" her smile faded and she nearly looked pained at her realization, "You old love, you don't _know_."

"Don't know what?"

Beryl's eyes widened, her head shaking, "He asked you 'cuz he'd have liked to have had some babies with _you_."

"Don't be daft!" Elsie gasped.

"It wasn't that he never found the right woman, it's that the right woman never had a _bloody clue _how he felt about her!"

Elsie was visibly flustered, "Even if, by some _wild _stretch of the imagination, you were correct —" she sighed deeply, "—it's too late now, so it hardly matters."

"It's not too late. It's _never _too late. It's not like people die when they're fifty, you goose! You could have another fifteen or twenty _years._"

Elsie shook her head sadly, her voice low and suddenly faltering. "I may _not._" she pressed her chin against her hand, her eyes tearing up "They found something on my mammogram."

"Oh, Elsie." Beryl said quietly, "Have you had a biopsy?"

"I actually have an appointment I need to step out for this afternoon. " she reached up to wipe a tear from her cheek.

"I'll come with you," Beryl said without hesitation, "If you want me to. If — if you don't want to go alone."

"I —" Elsie hesitated, then sighed. "Actually, Beryl I would really appreciate your company."

"Of course, love." Beryl said, reaching across Elsie's desk to grasp her hand. "It's all gonna be fine, you know that right? No matter what comes of it. You won't be alone for a moment if you don't want to be."

* * *

"Dr. Painswick's out sick today," the unit clerk said as Edith strode by the registration desk. She paused, turning, her brow knit in a concerned frown.

"Is she ill?"

The clerk shrugged, "Dunno, but she's not coming in today so you'll have to take her caseload." she said, nodding to a stack of piles on the desk. Edith sighed, reaching over the counter. Gathering them into her arms, she made her way through the unit to the small room she used as an office. It was usually used for the younger patients and as such as filled with children's toys and games. There was a rather imposing sand table in the corner that she almost _always_ managed to bump into as she shuffled her way through building blocks and stuffed animals to the desk.

She sighed wearily as she opened the first chart — a twenty-two year old female admitted thirty six hours ago from the emergency room. The girl had been found wandering greater London on foot and had been brought in by a shopkeeper who was closing up for the night and noticed that the girl didn't seem quite right. Flipping the page, Edith anticipated a routine tox screen, probably revealing any number of drugs in the girl's system to account for her behavior, but the labs had all be negative; the girl hadn't even had so much as a paracetamol.

Turning back to the girl's admit note, she scanned for her room number and pushed the other charts aside. Rising from the child-sized desk, she wiggled out from behind it and headed out into the long hallway.

Knocking on door #17, which was not closed, just pulled-to give the illusion of privacy. Pushing the door gently, she stepped into the room and saw that its occupant was sitting up in bed, hugging her knees tightly to her chest.

"Stephanie?" Edith said, "I'm Dr. Crawley — Dr. Painswick isn't in today, she's asked me to look in on you this morning."

The young woman looked up, a bit drowsy either from sleep or whatever sedatives she'd been given, and offered Edith a tiny smile.

"There're a_ lot_ of Dr. Crawley's in this hospital, you know. Maybe they should rename it Crawley Hospital?"

Edith smiled, sitting on the edge of the girl's bed. "Most of the patients here just call me Dr. Edith."

The girl nodded, pulling her knees tighter against herself.

"Stephanie, do you remember anything from the other day? Before you came here?"

"I woke up in the emergency room — I'm not sure how I got there."

"You were brought in by ambulance — you'd been running about the city, disoriented. Someone saw you and thought, perhaps, you were in trouble."

"Was I?"

"That's what we're trying to figure out." Edith said, opening Stephanie's chart. "Are you taking any drugs?"

"No."

"Have you smoked at all? Maybe something at a party?"

Stephanie shook her head.

"Any pills?"

"No, nothing. I'm pretty boring."

Edith smiled, "Not boring, _responsible_ maybe — not boring. You're quite serious about your studies then?"

"Yes, I want to be a teacher."

"That's a marvelous aspiration to have."

Stephanie furrowed her brow, bringing her thumbnail to her lip and biting it gently. "I do,_ um_ — well, the last thing I remember before I was here — I'd had a _horrible_ headache. I get headaches a lot, but nothing seems to help them. Mostly I sleep. I missed class on Monday and I just. . .slept, I guess. Until I woke up here."

"Does your head hurt now?"

"Not as much."

"Do you have any other symptoms that go along with it?"

"Well — I'm not sure. I don't think so."

"How are you doing in school?"

"Fine. I'm set to graduate in the spring."

"Oh, that's wonderful." Edith made a few notes in the girl's chart. "Are you feeling stressed out — more than you can handle, perhaps?"

"I don't think I'm any more stressed than any other person." Stephanie said flatly, "I don't know why I was wandering around but if what you're asking is,_ am I crazy_ —well, I don't know. Aren't you supposed to tell me?"

"We'll figure it out together," Edith said, closing Stephanie's file. "But there is someone else I'd like to ask about your symptoms."

"Another Dr. Crawley?" Stephanie asked, raising an eyebrow incredulously.

"No," Edith said, rising to go. "Dr. Hughes."

* * *

"You're awfully quiet," Violet said, stirring milk into her tea. She looked across her desk at Isobel, whose mug of tea went peculiarly untouched.

"Sorry — didn't sleep well."

"You look well rested to _me_. You haven't got those unsightly dark circles like you used to when Matthew was a boy."

"Oh, why thank you." Isobel said, "Good to know I'm not as _unsightly_ as I once was."

"I just mean to call you out on your lies." Violet said, sitting back in her chair.

"What lies? You just said I've hardly spoken — how can I be lying?"

"Fine, not lying —_withholding_." Violet narrowed her eyes, "You know something and you're not telling me."

Isobel sighed, removing her glasses. "It's not my news to share."

"But it's troubling you, obviously."

"Well," Isobel said, hiding a small smile, "I wouldn't say it's troubling me."

"Oh?" Violet said, her curiosity piqued, "Good news then?"

"Quite."

"_Hm._" Violet grunted, "_Well,_ I'll find out from someone, if not you." she gave a smug giggle, picking up her tea cup, "Nothing stays a secret from me for long."

* * *

** _both the bit about the re-sterilization of trays and the standing against the wall so you don't fall on anything if you faint came directly from my experience observing surgeries!_ _That's pretty much what I was told by the scrub nurses verbatim, ha ha. _


	13. If Memory Serves

**A/N: You guys are amaaaazing! Thank you for all your delightful reviews, as always, and now my PMs are on haha, so I will do my best to respond here and on Tumblr! ****_The saga continues . . ._**

* * *

The twinkling jingle of her cell phone jostled Cora from sleep. She'd woken up a bit when Robert had risen hours before, but had easily fallen back asleep once the cold spot in the bed where he'd vacated had warmed again. Groaning, she reached for her phone, patting the nightstand blindly as she pressed her face into the soft delight of her pillow.

Squinting, she saw that she had a text message — _Ros. _ It was nearly ten in the morning, surely she'd be working. Besides that, her sister-in-law was hardly one to text.

_ROS (9:45 am): Are you awake? Can I stop over? _

Cora yawned, finagling the phone into her slow and sleepy hands.

_CORA (10:01 am): I'm just up now, but come over. I'll put coffee on. _

She let the phone drop into the heap of blankets, disappearing into the white cloud into which she curled. She closed her eyes tightly, resisting the sunlight streaming in through the window and had to ask herself if it was Saturday — why else would Rosamund want to drop by?

It wasn't though; she knew it was only Thursday. Tomorrow she had her ultrasound and Sybil would be home by dinner. She smiled at the thought, though her mirth was quickly displaced by a swell of nausea that rose up in her belly. Sitting up slowly, she hummed deeply; a trick she'd learned by the second month of her pregnancy with Edith. The vibration in her chest and mouth bought her a little time; time enough to find a bin or, better yet, a bathroom. Miserable though she felt now that she was fully awake, she couldn't help but be content. It wouldn't be forever and the gift at the end was well worth the suffering. Life had proven that to her three times already.

She'd worried when it took them almost two years to get pregnant with Mary. They'd began trying before they'd even returned from their honeymoon. With Robert having completed his residency and, they hoped, moving on to a period of predictability in his career (not to mention some financial security, even if the same could not be said for the hospital itself) he explained that there was a window during which they would want to have all their children; however many they decided that was to be. Every decision had to be calculated and lined up to his career timeline. He had a very clear picture of his trajectory, as did the rest of the Crawley family, _as did the hospital itself_ which was relying on him to lead it out of financial ruin (with his wife's money, of course). Cora was happy to oblige; she just wanted to be a mother.

She just wanted something to _do _with her days.

When Mary was born, Robert immediately began plotting out the next child, hence how Edith came along just eighteen months later. Having found themselves back on their timeline for having a family, Robert relaxed. He had two little girls who adored him, a wife who took to motherhood straight away (or, at least, was able to convince him of it) and with a few years to spare before he'd need to be thinking about climbing the next rung on the career ladder, he thought perhaps it was worth trying for a son.

Cora could remember the conversation vividly. Mary was five, Edith almost four, and both were nestled into their parent's bed with the chicken pox. Cora was exhausted; Robert pulled long hours at the hospital caring for the sick and injured while she tended to the sick at home. She was frustrated to the point of tears when he crawled into bed, pulling sleeping little Mary into his lap and examining her arm closely.

"_These look to be doing better," _he'd said, "_how's Edith's fever?"_

"_Down, but not gone." _

He'd nodded, settling Mary back into the bed and reaching over to look at a rather sore patch on Edith's upper back. "_Where's the calamine lotion, love? I'll put a bit more on while she's asleep. She can hardly protest if she's out cold."_

"_I've been putting it on, Robert — it hardly soothes her. Just let her sleep." _

By which she really meant _just let me sleep. _

Robert sighed, "_I suppose it's better they get it at the same time. At least you don't have to entertain a healthy child while also tending to a sick one." _

"_I guess," _Cora yawned, "_It's exhausting, though. And they're both miserable and it makes me tear up to watch them be so sick and know I can't really do anything about it." _

"_I was thinking, darling—" _Robert began, "_We may want to start trying again. You know, see if we can get a boy this time." _

Cora laughed, almost bitterly. "_Can it at least wait until they're well?" _

"_Of course," _Robert huffed, "_I just mean to say it would be preferable if you were pregnant by early spring. The baby would come before Christmas, I could extend my holiday to help and then we'd all be back on our feet in time for the new interns—" _

"_Well, what if it doesn't work out quite that way?" _

"_I think it will." _Robert said, reaching for his book on the night table, "_And in any case, it'll be the last." _

She'd gotten pregnant with Sybil right on schedule, but with two under the age of five, a husband who wasn't home nearly enough and the pressure of the baby's gender, the pregnancy had not been a pleasant one. She was sicker, more run down and short-tempered than before and began to harbor a quiet resentment for the whole situation. Of course she wanted the child, but she was hounded by the worry that if it _was _another girl, Robert may not. Or, at the very least, he'd be disappointed beyond measure.

Sybil's birth had been far more traumatic, no doubt because Cora had not fared well over the course of the pregnancy. She hadn't gained much weight, was anemic and to make matters worse, Robert had been on call when she went into labor and so she spent the majority of the night alone. Rosamund had offered to watch the girls and so that left Cora with only one person: _Violet._

Robert's stately mother, who ran the hospital with an iron fist and ran her relationships and domestic life with rather the same mindset, had positioned herself regally at the corner of the delivery room, barking orders to the nurses and all but ignoring Cora's discomfort until the doctor announced she could start to push.

"_Don't tell her to push," _Violet said, hovering over Cora as she looked at the fetal monitor, "_See? There are decelerations — the cord may be wrapped around the baby's neck." _she turned to her daughter-in-law, "_Cora, don't push yet. Just sit tight a moment."_

_This can't be happening, _Cora thought. Not only was her husband nowhere to be found and she was about to give birth to their third child, but her mother-in-law was now fully in charge of the delivery — a fate she'd not have wished upon her worst enemy.

"_With all due respect, —" the young obstetrician had said. _

_Violet laughed, "In my experience any sentence that begins 'with all due respect' is going to be rife with **dis**respect. Now, enough chatter — is there an operating theatre available? I would highly recommended a cesarean." _

"_You're not her doctor—"_

"_No," Violet snapped, "But the baby currently in distress is my grandchild!" _

_At which point Robert burst in, struggling with his scrub cap and a look of despair on his face, having no doubt been ruminating on what horrors awaited him in the birthing suite with his wife moment's away from delivering and his mother calling the shots. _

"_Robert, please talk some sense into this man!" Violet said, but Robert ignored her, going to Cora's side and taking her hand._

"_Darling, I'm terribly sorry —" _

"_Robert—" she responded, gripping his hand, "There's something wrong." _

_His eyes flicked up to the fetal monitor, he squinted, then looked over to Violet. "Is there an operating theatre available?" _

"_Would you like to do the cesarean yourself?" The obstetrician said, snapping his gloves, "Pehraps your mother can scrub in to assist?" _

_But as the doctor looked up, noticing the distress indicated on the fetal heart monitor, he relented and before she knew what was happening, Cora was in the freezing cold operating room. _

"_I can have the baby out in thirty seconds," the obstetrician had said, lowering the scalpel out of Cora's view. She turned her head toward Robert, who was craning his neck above the drapery to watch with a trained eye every move that the surgeon made. _

_Nauseated and suddenly quite sleepy, Cora let her eyes flutter closed. _

_The next thing she remembered was opening her eyes in the recovery room and seeing Robert sitting at the foot of the bed, a tiny bundle in his arms. _

"_Is it a boy?" she'd croaked, her mouth so dry it made her throat ache to even breath. _

"_No, a girl." Robert whispered, "And she's perfectly healthy. And perfectly gorgeous." _

_He'd turned the blanket toward her and the moment that Cora saw the baby's face, she was startled out of her sleepy haze. Sybil was easily the most beautiful baby she'd ever seen, and not even because she was her own. _

"_Cesarean babies are always the most beautiful," a voice said from the doorway. Cora let her head turn slowly and saw Violet standing there, arms folded across her chest. "They don't get squished up and red-faced by the birth canal." she giggled a bit, stepping into the room. "Mary and Edith were rather like Christmas hams for the first few days. . ." _

"_How can a baby possibly be so —" Cora inhaled, reaching a finger out to lightly stroke the baby's cheek: perfectly rosy, all peaches and cream skin. _

"_Pretty? Well, as I said, avoiding the trauma of a vaginal delivery —but—" Violet sighed, reaching down for Cora's hand. "Having a beautiful mother certainly does help." _

She must have drifted off into the memory, because the sound of the front door opening jarred her awake.

"Cora, love?"

"Sorry, Rosamund!" she called out, "— give me a minute!"

She threw the covers back and stood — albeit much too quickly, throwing off her center of gravity. Head spinning she lunged for the bathroom as she heard Rosamund's footsteps on the stairs.

"Cora — oh, _darling_! Are you ill? You should have told me you weren't well, I wouldn't have called on you—"

Spitting into the sink, Cora called hoarsely toward the bedroom. "No, no. Not ill, Rosamund."

Her sister-in-law appeared in the doorway, her eyebrow raised incredulously. "Not ill, well, I beg to differ love."

Cora heaved and Rosamund tutted, "Oh dear. . ." she said, reaching a hand over to stroke Cora's back.

"Thank you," Cora coughed, looking up at Rosamund. As soon as her face had turned to look up at her, Rosamund gasped.

"Oh, Cora. . ." she said, "You are absolutely _aglow_."

"Hardly!" she said straightening slowly, her hands gripping the sink, "Sweaty more like it."

"Well. . .like I've always said. . ._pregnancy_ suits you. . ."

Cora blinked, "Robert's told you then?"

Rosamund's eyes widened as she pressed her hand to her chest. She laughed, reaching over to grab Cora, wrapping her in a warm embrace. "No, darling — _but you just did!_"

* * *

"Anna, may I have a word?"

Looking up from her paperwork to see Dr. Hughes hovering over the counter of the nurses' station, Anna smiled. "Of course." she said, pushing herself up from the chair. "Just let me tidy up these notes—"

"Beryl will keep an eye on them," Elsie said, "I only need you for a moment."

Anna nodded, noticing there was a glint of nervousness in Dr. Hughes' eyes that mirrored the look she'd seen in the hallway yesterday. "Is everything alright?"

Whisking Anna around the corner and into an empty patient room, Elsie sighed. "Nothing's the matter, but Beryl and I need to step out this afternoon — safe to say for about an hour. I was hoping that you would feel up to the task of running the unit in our absence."

"Well, — if you think me capable—"

"I do." Elsie said, "The census is down a bit so I thought—"

"Well, don't _say _it is," Anna giggled, "It's a superstition, you know. The minute you say the census is down there will be a bus accident, _God forbid,_ and we'll be full to the _brim._"

Elsie offered her a small smile, "I'll say a few Hail Mary's in hope any karmic renderings hold off until we return."

"You're sure nothing is the matter?" Anna said quietly, "If it's none of my business you can just say so."

"Anna," Elsie laughed, "You worry after everyone like a little hen." she regarded Anna quietly, then let her gaze fall, "I wonder, at times, who worries after _you._"

Though she'd meant it kindly, as soon as she'd said the words she saw a flicker of hurt on Anna's face and immediately wished to suck the words back into her mouth.

"I'm sorry, Anna. I didn't mean—"

"Oh, I know." Anna said softly, "I _do_ worry too much. I know I do."

"It's only because you've a kind heart." Elsie said, "It's why you're such a good nurse."

"You think so?" Anna brightened, "You think I am?"

"Why else would I leave you in charge of the entire unit, Anna? Good God, girl. It wouldn't hurt you to think a little higher of yourself."

Anna's face flushed and her gaze fell from Elsie's. "I've disappointed you?"

"Anna," Elsie said, furrowing her brow. She reached a hand over and tentatively rested it on the girl's forearm. "No — you haven't in the least. What's this about?"

"I'm sorry," Anna said, her voice raw, "It's just — I don't know, sometimes it all gets to be a bit much."

"I can ask someone else. . ." Elsie said quietly.

"No, no — not the work." Anna said, "Other things. _Life, _I suppose. "

Elsie nodded knowingly. I won't pretend to know for sure what's upset you, but I was young once so I think perhaps I have a fair idea. Take it how you will, but as an older woman I feel it's _my duty_ to say it: a broken heart can be as painful as a broken limb."

Anna blushed. If Elsie'd caught her out she hadn't meant to; she'd only wanted to offer what she could by way of compassion.

"Like I said, take it how you will." she laughed ruefully. She gave Anna's arm a final pat and sighed, "Beryl and I will be back by 2 o'clock. Of course if anything dreadful unfolds, you may page me."

Anna nodded, "Thank you Dr. Hughes."

"No, no — thank _you, _Anna. You've taken a weight from my mind."

"You've from mine as well, Dr. Hughes." Anna said. Elsie turned back to her. "I'm not one who is worried after. So I'll happily take any advice you'd like to offer."

Elsie softened, giving Anna a small smile as she opened the door and ushered her back into the hall.

* * *

"Thank you, pet." Rosamund said, taking a mug of coffee from Cora.

"No trouble at all," Cora said, though she couldn't hide the wrinkling of her nose at the scent. She pushed her own mug away and reached instead for a glass of orange juice she'd had the foresight to pour. "Not that I'm not happy to see you, Ros but —"

Rosamund waved her off, "I'm playing hooky. Don't ask too many questions, you'll spoil it."

"_Naughty."_ Cora grinned, "Did you have anything in mind?"

"Not until you broke your most exciting news to me, darling." she said, leaning across the table, "I think the only thing _to _do today is go shopping."

"I think it's a little early. I haven't even had an ultrasound yet—"

"Not for the _baby,_" Rosamund laughed. "For _you._" she laughed over-top the rim of her mug, "Hell, for _me." _

Cora laughed, sipping her juice. "Sybil will be home tomorrow and I've still got so much to do."

"I can help — what do you need? Errands? Laundry?"

"You're really trying to avoid work aren't you?"

Rosamund shrugged, her spirit dampening a bit. "Well — I've just had a lot on my mind. I needed a mental health day from mental health."

"Edith hasn't done anything to stress you — ?"

"No, no. It's just — well, I suppose I worry for her." she smiled sadly, "I know what this job can do to a person. For every person we help there are ten more that we never can."

"The last time I spoke to her she seemed well enough."

"She is. Really it's just — there's a patient with a husband who is around and — well, there are children involved. It's all very complicated and —" she trailed off, shaking her head.

Cora nodded knowingly. "You're remembering Mr. Foyle."

"I didn't come here to dredge up old ghosts from the past, Cora." Rosamund said curtly.

"You rather walked into the topic yourself, Rosamund." Cora said evenly. Rosamund eyed her — yes, Cora Crawley was _definitely_ pregnant — if her uncharacteristic aggression was any indication.

"I'm sorry Cora. I admit it has been on my mind as of late. I had words with Edith and she did manage to throw it in my face."

Cora frowned, "She shouldn't have done that."

Rosamund shrugged, "I think we all underestimate her. That girl has a fire in her."

Cora smiled, but almost immediately recoiled, another wave of nausea hitting her. She tried valiantly to fight it, but rose quickly and ran to the sink. Rosamund chuckled, pouting playfully at her poor sister-in-law. "And it looks like _this_ one will too."

* * *

As they strode side by side through the corridors of Downton Hospital, Dr. Elsie Hughes and Beryl Patmore looked to be about as mismatched a pair of friends as two could be: Beryl tottering along with her shock of red hair and stern face, and Elsie with her dark but delicate features and air of calm repose. They'd known each other so many years now they'd could hardly recall just how they met, exactly. But Beryl could remember quite vividly the first time she'd wished she'd _never met_ the Scottish doctor.

_She'd been a bloody nurse since she was twenty-two years old; if anyone knew about what did and did not belong in the store cabinet, it was Beryl Patmore. The set of bollocks of the newest import to the unit — a buxom Scot with a frosty stare whose stethoscope had an annoying tendency to rattle against the ever-changing score of broaches she wore on the lapel of her jackets, the thwacking announcing her long before her thick brogue did. _

_When she'd come to Beryl to inquire as to why the dissoluble sutures weren't kept in a particular drawer over another — the latter being where the doctor apparently felt they belonged — she could hardly muffle her contempt. _

"_Because, Dr. Hughes, that's where we've always kept the dissoluble sutures." she said evenly, folding her arms across her chest defiantly. Dr. Hughes matched her stance, clearly not one to go down without a proper fight. _

"_Well, I think they'd do better in the upper left hand drawer. That way they'd be away from the overhead lamps — which, as you know, tend to run hot." _

"_I do know that," Beryl said narrowing her gaze, "and I understand that what you may not realize is that if they were in the upper left hand drawer they'd be closer to the radiant heat." _

"_That well may be —" Dr. Hughes said, licking her lips contemplatively. "I suppose we've reached an impasse. They can't remain where they currently are, you've come up with a reason not to take my suggestion—" _

"_Because your suggestion isn't any better than the problem you've presented to me, Dr. Hughes!" Beryl spat, "This is the third time this week that you've come in here, marched into the nurses' station like you're bloody Rob Roy defendin' his honor, trying to tell me how to do my job—" _

"_I wouldn't dream of telling you how to do your job." Dr. Hughes said._

"_Oh, you wouldn't?" Beryl scoffed. _

"_No," Dr. Hughes said, her arms dropping and her hands slapping hard against the side of her thighs, she took a step toward Beryl and looked down at her, cobalt eyes boring through the nurse's gaze. "Because __**you **__are a nurse — and __**I **__am a doctor!" _

For the first year Elsie was at Downton she and Beryl sparred over everything — but after a while the exhaustion of the job, the sense of humor they had to have when things went wrong, and their shared dedication to their work helped them to develop a friendship. By the time they had both celebrated twenty-five years of service — which coincided with their respective periods of _menopause_ — their occasional rows were far more sisterly than anything else. There was an unspoken bond between the two women that had carried them through many a late, rough night at Downton Hospital — and Beryl looked up at her friend now, whose face had fallen and was marred with the heavy lines of age and fear, and she hoped that they would get through whatever came of this day, too.

* * *

"Rather a ghost town around here today, isn't it?" Dr. Carson said, furrowing his brow at the nearly empty nurses' station. He'd purposefully stumbled onto the pedes unit in search of Elsie, wanting to tell her about his chat with Dr. Crawley — but mostly, wanting to check in on the patient they'd tended to together last night. Or, if he was honest, _mostly _to check in on the doctor herself.

Anna hustled around the corner of the nurses' station, her arms overflowing with patient charts.

"Dr. Hughes has stepped out for an hour or so —" she said, scooting past him and heading down the hall, "You can check back later if you need her for something — or, well, you could always leave a note in her office?"

He nodded — waving to the girl, though she was already down the hall and tucked into a patient room. He looked around him; truly no one was in sight, everyone off either on their lunch he supposed, or tending to a patient. Sighing, he took off down the hall toward her office. Though he felt a bit odd going in when she wasn't there, it wasn't like he hadn't on occasion over the years for one reason or another — grabbing a copy of a medical journal from her shelf, leaving her cup of coffee if she'd stepped out to a meeting before he had a chance to see her in the morning, stopping in to grab her pager when she'd left it behind and begged him to pick it up for her on his way to some meeting they would be stuck in for hours.

Her office was not so unlike his own in terms of layout — he supposed they probably all looked the same — but hers was far homier: warmer tones, more feminine fixtures — and it was _never_ as neat as his. While he had a place for everything and everything was always to be found in its place, Elsie's desk tended to be what she would call "organized chaos"; it was never a _tip, _but paper did tend to stack up. Books occasionally piled up on the floor next to her desk. Often her jacket would be taken off in haste and draped over a chair.

But he liked these little signs of her. He looked for them everywhere.

He glanced between the piles of paper on her desk for a slip of paper or a Post-It on which he could write a brief note. Pulling his pen from his shirt's front pocket, he stuck it between his teeth when he saw the corner of a purple pad of Post-It's peaking out from beneath a stack of folders. Carefully pulling them out — trying his best to avoid an avalanche of paper— he managed to nudge his elbow into a stack of paper to his right and a few notes fluttered down to the floor.

"Damn," he cursed, bending down to pick them up — he hadn't meant to even look at them, certainly wouldn't have expected to find anything he shouldn't — but when he saw the letter addressed to her, on Dr. Richard Clarkson's letterhead, he braced his hand against her desk.

_I received the results of your routine mammogram...highly stratified lesion...left breast... suspicious for malignancy. _

He felt as though his breath had been stolen from him. Struggling to stand, he dropped the paper as though it were burning his hand and took a step back from her desk. He paused a moment, unsure of what to do, and then uncapped the pen and scrawled a single phrase on the violet note pad, sticking it resolutely to her computer screen where it was not likely to be missed:

_Page me when you see this. _

_Please. _

— _C. C. _


	14. Nexus

**_A/N: Hi loves! Oh, thank you for your reviews – my goodness. I feel quite humbled! Am trying to respond over the weekend! Here's a little chapter to get you through the weekend. Don't worry Cobert shippers, you get some next chapter. This one is Chelsie heavy with like 5 seconds of Banna, lol._ **

* * *

Anna gasped as an arm slid around her waist.

"_No chance of stealing you away for lunch I see." _

She turned, looking up at John who smiled sympathetically down at her. "Don't sneak up on me like that — you know how jumpy I am." she sighed, "And no — I'm afraid I haven't a spare moment."

"I didn't even expect to find you here — wasn't today your day off this week?"

"Phyllis called in, so I'm covering for her."

"When _was _your last day off?"

Anna pursed her lips, not responding. After a moment she bent over to unlock the computer she was standing in front of, "I don't mind, really." she insisted, hoping she wasn't leaving him room enough to question the hesitation in her response.

"Well, I hope we can have a night together _not spent _in an on call room —"

"John, _please." _she hissed, "Someone could hear you."

John laughed, "Anna, there's absolutely _no one_ here."

Just then, they heard footsteps and both looked up to see Dr. Carson making his way out of Dr. Hughes' office, walking briskly toward them. He looked as though he were about to be sick.

"Dr. Carson — is everything —?" John said, stepping out of the nurses' station and into the doctors path.

"All's well, Dr. Bates." he turned to Anna, "Is Liddy Rout still in intensive care?"

Anna nodded, "They've not moved her, at least not to my knowledge."

Dr. Carson nodded, "Good. Thank you."

"You're sure everything is okay?"

"Yes, Anna." Dr. Carson said sharply, "I'm not one of your patients."

Anna flushed nervously. She hated being called out _at all, _but particularly by a man. _Particularly_ by a man she admired and wanted to impress.

"I'm sorry—" she stuttered, but the moment to recoup had gone; he was already striding purposefully away from them, headed toward the nursery.

* * *

"It's always a pleasure to see you, Elsie." Dr. Clarkson said, pulling the rolling stool across the examination room toward her. She'd told Beryl she could stay in the waiting room if she preferred, but she'd eagerly accompanied her — fully intending to stay true to her promise that Elsie wouldn't have to go through this alone. Although they didn't talk much about their personal histories, Beryl had always gotten the sense that Elsie's family — whatever was _left,_ anyway — was not a topic she would ever willingly broach. All she knew for certain was that both of her parents had died, she _thought _perhaps she had a sibling (occasionally there would be correspondence on her desk from an address in Lytham Saint Anne's) but she was never sure if Elsie would _want _her to know one way or the other.

"I only wish it were under better circumstances." Dr. Clarkson continued, his shoulders rising as he sighed, straightening his glasses as he looked down at the notes he had in hand. "As you already know the results of your mammogram were abnormal. Now, I won't insult your intelligence by sidestepping the clinical relevance of what was seen."

"I'd appreciate it if you were honest and entirely thorough in your course, Dr. Clarkson. I see no point in sparing me the reality of the situation."

"I had no intention to," he said, "But it's early yet — it may not be cause for concern and, even if it is, it may well be early enough that with intervention and treatment. . ." his voice trailed off. He looked up from his notes, "Elsie, treatment for breast cancer — for all cancer, really — has come a _long _way since we were in medical school."

She nodded, "It has."

"So has the diagnostic medicine involved." he said standing, moving toward the examination table. He turned briefly to Beryl, who sat nervously in a rather uncomfortable looking chair.

"Do you want me to step out —?" she said, looking up at Elsie.

She shook her head, "I don't mind, Beryl. God knows we've flashed our tits to one another _plenty _of times in the locker room, getting out of scrubs after a late night!"

At this, Beryl laughed — Elsie chuckled too, though as Dr. Clarkson moved to lower her johnny, she did feel her face flush.

"Have you noticed any changes yourself?" he said, clinically running his hand over her breast. It was such an odd feeling. Of course she'd had breast exams for years, had full gynecological work ups for _years and years_, and with her own medical background they were rarely more than an inconvenience in her otherwise busy day. But this was different; suddenly she was struck by the thought that, had her life been different, a man may have held her breasts warmly, _reverently _— not with the cold, forceful and purely clinical hand of a doctor. She knew she must be visibly blushing, and she had completely forgotten what Dr. Clarkson had asked her.

"I'm sorry?"

"Have you noticed any bruising, pain — discharge from your nipples?"

Her heart leaped up into her throat at the word. She felt like a _schoolgirl. _Beryl either sensed her discomfort or just couldn't stand not being part of the conversation —

"Didn't you mention last month that you thought you had a wonky lymph node under your arm?"

"Yes — but —" she shook her head slightly, looking up at Dr. Clarkson, who was still feeling her breast. His other hand moved under her arms, almost as though he were about to lift her like one would lift up a small child. "I had just had a rather nasty bout of bronchitis, so I didn't think much of it—"

"And was it on this same side?" he asked, gently palpating the side of her breast. She only nodded. He removed his hands, nodding for her to pull up her johnny. She did, eagerly, suddenly realizing how chilled she was by the room — and his hands, which had been particularly cold. She knew her nipples were poking through the fabric of the cover up but she couldn't be bothered to give a damn.

"Did you feel anything?" Beryl asked, leaning over to have a look at the notes Dr. Clarkson was making. He paused, then held up a diagram of a woman's chest, using the tip of his penlight to indicate an _x _on the lower part of the headless diagrams' left breast.

"I feel what I suspect is a solid mass, here, at the 4 o'clock position. I would estimate, based on exam as well as the imaging, that it's approximately 5 cm." he lowered the notepad and clasped his hands in his lap. "My initial recommendation would be a core needle biopsy, but I would not rule out a full excision." he paused, looking down at her chart, "Elsie — is there any breast cancer in your family? I saw no mention of it in your history."

Elsie swallowed, "Not of the breast. I had an aunt die of cervical cancer when I was a teenager; my mother's sister. My _mother _died of —" she hesitated. Dr. Clarkson looked up at her.

"Died of —?"

"They were never _entirely_ certain, actually." she said quietly. "She didn't receive proper medical care. Not until it was far too late but — I've long suspected she had reproductive cancer of some origin. Perhaps of the ovary."

Dr. Clarkson sighed, making notes. "You should have had more frequent screenings."

"I know."

"What — are you trying to say it's her own fault?" Beryl scoffed.

"Not at all," Dr. Clarkson said flatly, "But given that there was at least one confirmed reproductive cancer in your maternal line, I would say an excisional biopsy is reasonable. Especially given the size. If it does get any larger, it would probably distort the shape of the breast." he shrugged, "You'd not be able to ignore it _then._"

Beryl narrowed her eyes at the doctor; it wasn't as if he was talking to just _anyone_, he was talking to one of the most well-respected medical professionals at the institution, if not all of England. Where he got off being cheeky she couldn't begin to fathom.

"And what would that entail exactly?"

"A day surgery, I would think."

"But you could do the core biopsy _here_ — if we did that. You could do it here? In your office?"

"Yes, but —"

"Well, I'd prefer that."

Beryl threw her a look. "But Dr. Clarkson said —"

"I'd prefer the needle biopsy done _here _in your _office_ by _you."_ she said, ignoring Beryl's plea. "I don't want anyone in this hospital to know a thing about this. Not a soul, do you understand me?"

"I do, Elsie. I assure you I do — but you realize that if it's confirmed—if it's _cancer — _that you will most likely need to take a leave of absence. A sabbatical, even, for treatment. You won't be able to keep it a secret. Not in _this_ hospital."

"Well, we don't know that it is. Not yet." she said, tightening her johnny round her shoulders. "So, until we do, I don't want either of you to speak of it. To anyone. Not even your nurse, Dr. Clarkson."

He sighed, closing her chart and standing. "You've my word on it, Elsie but you know as well as I do that the walls of this hospital have ears."

He nodded to her, then to Beryl, and quietly left the room. Beryl just shook her head, handing Elsie her blouse. "I don't remember him being this much of an _arse_." she mumbled, turning to grab her purse. When she looked back at Elsie, she saw that she hadn't moved to dress, and was clutching the fabric against her chest.

"Oh, Els." Beryl said, slinging her bag over her shoulder. "You said it yourself, you don't know that it is."

Elsie closed her eyes, her hand coming up to cover her mouth as a small cry escaped her. She shook her head, then, composed herself, pressing her hand against her chest. She looked up at Beryl, her eyes damp.

"We spent all those years in school to learn how to prepare our patients for a moment like this and yet when it happens to _you —" _she shook her head, a tear trailing down her cheek. "Oh, God. _Oh God." _

* * *

"Well, you're looking _much _better than the last time I saw you, ducky." Charles said, lifting Liddy from her isolette. The baby yawned, squinting up at him. "You've pinked up a bit. I think perhaps you've what my mother would have called _peaches and cream _skin. Becoming on a baby, you see, but it would be perfectly ridiculous if anyone were to describe _me _as having such. I'm sure you couldn't even begin to fathom it, Liddy, but I too was once as small as you are." he bounced her gently in his arms and she cooed, waking up a bit. "I was once even quite ill — not sure that I was quite so ill as are at present, but gave my mother a proper fright. I had Rheumatic Fever, you see. Gave me quite the ruddy face for a time — the rash, you know, it can be quite severe." he paused, chuckling slightly. "Or, perhaps you don't know. You _are_ an infant. Anyhow, _I_ was one of the lucky ones. My ticker emerged relatively unscathed. But I know my mother sat by my bed every night for weeks, worried that I would die. I can't imagine how that must have felt. Though I suspect your poor mum would."

Liddy fussed, kicking her legs a bit. Charles laughed, lifting her up and pressing her gently to his shoulder, his hand making tiny circles on her back. "There, there. No need to fuss. Or — well, I suppose feeling as miserable as you do, you've adequate cause to fuss. Never mind. Carry on, Liddy. Fuss_ all_ _you please_." she looked up at him, her eyes wide open now, and her cries quieted to the occasional gurgle. "Ah, listen to me. Prattling on like an old fool. Well, at least I can rest assured you won't repeat any of it." he sighed, "The other doctor — from last night, Dr. Hughes, perhaps you recall her. Dark hair, very kind blue eyes — _lovely_ Scottish brogue. Tall, but not overly so. Although she does wear high heels so — perhaps she's not _actually_ as tall as I think. She's always smartly dressed. Very becoming in scrubs — and I assure you, Liddy, that can be said of a precious few." Liddy gooed in acknowledgement, "Yes, perhaps you've observed as much. But Dr. Hughes is a bit of a legend. It's a shame you're not older, you won't remember any of this — but someday, I'm certain, your mum will recount the story of how she saved your life." He let his eyes flutter closed for a moment, an old tune rising up from some memory, rumbling low in his throat.

_One girl, one boy_

_Some grief, some joy_

_Memories are made of this*. _

"I think she's a_ little_ young to remember that one, Dr. Carson."

At the sound of her voice he startled, turning toward the entry to the nursery. She was leaning up against the door frame and he immediately wondered how long she'd been there. Judging by the sly smile on her face, he figured long enough to make him feel a bit foolish. He wondered if she'd been back to her office yet, saw his note perhaps.

"I went looking for you earlier. Anna said you'd stepped out."

"Yes, I had an errand." she said — a bit too loudly, he thought. Her voice seemed odd, high-strung.

"Must have been urgent. I hope everything's alright?"

She glared up at him, "Yes, of course. Why wouldn't it be?"

"I—well, I just—" he laughed nervously, "I've known you a long time and I don't think you've _ever _stepped out for an _errand _in the middle of a shift."

She sighed, "Well, perhaps the years have softened me a bit, Dr. Carson." she said curtly, striding purposefully toward him. She bypassed him completely and bent over to look at the monitor Liddy was still hooked up to. He turned to say something and noticed that her skirt wasn't zipped all the way, her blouse billowing out over top of it. Without thinking he steadied Liddy against his shoulder and hip and reached a hand over to touch the small of her back —

Straightening up hard, she turned to him, "_Dr. Carson_!"

"Your zipper!" he said, pulling his hand back, disturbing Liddy in the process. She protested with an annoyed wail. "The zipper of your skirt is — it's not _done up_ all the way —"

Reaching behind herself to feel for it, her face went entirely scarlet. "What so you figured you'd undo it the_ rest_ of the way?"

He blinked, his mouth agape. "Dr. Hughes —" he sputtered, "Good God, _no. _Why would you even think —" he couldn't finish the sentence, was suddenly terribly confused about what had just transpired, about her reaction — what she thought he was insinuating. Had she stepped out to — was there someone, a man? Surely he'd know. Surely he would _know_ if she —

He lowered Liddy back into her isolette and took a step back from it. Having done up the zipper, Elsie smoothed her hands over the front of her skirt nervously, tugged at her blouse, tried to straighten it. He shook his head, reaching a hand up to rub his neck, which suddenly felt too flimsy to support the weight of his head. "I'm sorry." he offered, and he was. He just wasn't sure for what.

She sighed deeply, "No harm done, Dr. Carson. I'm sorry if I overreacted. I've had rather a trying week and I am looking forward, very much, to the end of it."

He stared at her a moment, then let out a shaking breath. "Anything I can do to help?"

Flicking her gaze up at him she appeared to consider the offer a moment, but then shook her head dismissively. His heart sunk. He'd hoped that she would confide in him. Even if there _was_ someone for her to. . .even if there was someone else, he didn't want to lose her further. He wanted to be her friend, at least — surely she'd not begrudge him that.

"No, Dr. Carson—but thank you."

She made to step by him and he put his arm out to halt her, pressed his palm against her shoulder. Looking at it, then up at his face, he thought he saw her flinch for a moment. Lifting his hand and bringing it back to the nape of his neck, he spoke low.

"You'd tell me, wouldn't you? If something was. . . wrong?"

"Yes," she said simply. "I would."

As she stepped away from his hand and headed out into the hallway, she convinced herself entirely that she had not lied to him. If something _was _wrong she would tell him.

She'd have to.


	15. Mass Effect

_**A/N: You guys are fucking rad. Honestly. I do it all for you, babies. Thank you for all the lovin' here and on Tumblr. So, as it turns out in the division of chapters next chapter you get your sweet Cobert fluff. I'm trying to divide up the bigger parts — wrote like 15 pages in one sitting OOPS. So next chapter we'll have finally made it to Friday. 50,000 words and our timeline has marched ahead 5 days. LIKE REAL LIFE SOAP OPERA.**_

* * *

Edith didn't often have the occasion to leave psych, least of all on a day when she should have been running the unit in Rosamund's absence — but the patients were in Thursday afternoon group and she had a moment to steal herself away to find Dr. Hughes.

She waved to Anna as she passed by the nurses' station — she'd always liked her and secretly wished she'd leave pedes and come down to Psych. Edith would have liked to have her as a friend. Frankly, she'd like to have _a _friend. Anna seemed sweet, kind of quiet — something Edith valued in others, since her idea of a perfect day off was doing laundry and reading. In fact, it had been the reading she'd done over her lunch (a microgreen salad with balsamic vinegar, like any other day) that had convinced her Stephanie's symptoms were, perhaps, not _strictly_ psychological.

She readjusted the books, folders and files in her arms as she stood before Dr. Hughes' office door, preparing to knock, when it opened and startled her.

"Oh! Edith, _goodness_." Elsie laughed, her hand flying to her chest in surprise.

"I'm sorry Dr. Hughes — if you're on your way out I can come back. I should have phoned first —"

Elsie waved her in, stepping back to open the door. "I was only stepping out for a cup of tea — but it can wait. Come in, come in." she turned and made her way back to her desk, looking over her shoulder as Edith settled into a chair. "How are you settling in up in Psych?"

Edith smiled, heaving her books into her lap, steadying them as a few folders threatened to slip from the pile. "Very well — _I think_. But I have a patient, a young woman, and I wanted to ask if you'd consult on her case." she said, sliding a folder across the desk to her. "I'm sure you've a heavy caseload but —"

"Happy to help if I can." Elsie said, sliding her glasses down onto her nose and as she opened the folder. "What's Dr. Painswick's diagnosis?"

"She's not on the case at the moment — I mean, she was here for her intake but, she's not in today to consult with and I've been put in charge of things and — well, I don't think it should _wait_ —"

Studying Stephanie's chart, Elsie hummed in acknowledgement, then furrowed her brow. "She presented with a dissociative fugue but when you spoke with her she seemed neurologically sound?"

"Yes. _Anxious _— which would be expected of anyone— but she was oriented, present—" Edith smiled, shaking her head slightly, "Spirited, quite an acerbic wit about her."

Elsie chuckled, "Well, _that_ bodes well." As she flipped through the chart, she paused — biting her lip as she read. "And the headaches?"

"Well, that's why I'm asking you."

"I'm not a neurosurgeon—"

"I know, but you could make the preliminary diagnosis and refer?"

"If it's—"

"I'm not ruling out that there's a psychological component, but I've got a hunch."

Elsie closed the folder, folding her hands atop it. "A tumor."

"Not necessarily malignant — but I think it needs to be ruled out. In the event it's cancerous, I don't want to waste time on psychiatric diagnostics when she could need surgery or chemotherapy —"

"Your hunch is not unfounded, Edith." Elsie said, removing her glasses. "I don't typically suggest that we, as physicians, operate on instinct alone but you've done well to bring her case to me."

"Thank you, Dr. Hughes."

"Go ahead and order the imaging — CT, MRI — let me know when they've resulted and I'll speak to her. Meanwhile, if needed I can place a call to the pediatric neurosurgeon at St. Mary's. . ."

"I know my father just interviewed a young surgeon — I'm not sure if she's been selected yet, but he's been anxious to fill that neuro vacancy. Dr. Swire?"

"I haven't heard of her — pediatric neurosurgery?"

"Yes."

"Hm. Well, I'll have to do my research."

"Thank you for your time, Dr. Hughes." Edith said, gathering her books.

"My door is always open, Edith." Elsie said kindly, "Keep up the good work."

Edith smiled, giving her a small nod as she turned to leave. As the door clicked softly shut, Elsie let her head rest in her hands a moment, taking solace in the darkness of her closed eyes. On her desk, her phone vibrated loudly, shimmying across the desk, and she startled. She huffed out an annoyed breath, popping her glass back down onto her nose, and squinting at the phone.

**CHARLES CARSON (_3:31 PM_)**

I am Surrey about earlier.

**CHARLES CARSON _(3:32 PM)_**

SORRY not Surrey. I am not used to this contraception.

**CHARLES CARSON (_3:33 PM_)**

CONTRAPTION.

**CHARLES CARSON (_3:33 PM_)**

I am just trying to apologize for my behavior. You are a respected colleague and frond.

**CHARLES CARSON (_3:34 PM_)**

FRIEND. I surrender — may I treat you to afternoon tit?

**CHARLES CARSON (**_**3:34 PM**)_

TEA. TEA, DR HUGHES.

Elsie wanted to respond but the phone shook in her hands as she struggled to contain her laughter. She finally let go, guffawing until her eyes teared up, and responded simply:

**ELSIE HUGHES (_3:36 PM_)**

Just about to step out for a cuppa — shall we walk together?

* * *

"Cora, _darling,_ get over here! You know damn well you won't need _actual _maternity clothes until at least month eight." Rosamund tutted, grabbing Cora's hand and pulling her away from the rack of clothes she'd be perusing. "Knowing you you'll still be a size _four _when you deliver."

Cora blushed, "You tease me about my body worse than my mother."

"Only because I'm so terribly jealous." Rosamund said, hefting a pile of sparkly blouses into Cora's arms. "You're terrifically pretty."

"Maybe _twenty years_ ago."

"Stop it," Ros said, "What's your secret? Your skin has aged _so _well. God, you should see me without makeup — no, _no _you shouldn't. You'd faint." she sighed, flipping her long fingers through the rack of clothes, "Getting old is so terrible."

"You're hardly old, Ros." Cora said gently, "And you always look fantastic. I've never met a woman so well dressed in my life." she settled in next to her in the aisle, watching her narrow her eyes at a sweater she'd pulled from the rack. "I used to be so intimidated by you."

"Piss off, you were _not_." Rosamund said — clearly delighted.

"Of course I was! Robert's beautiful, worldly, wildly successful sister? I think I was more concerned that _you_ wouldn't like me than of Violet disliking me. I suppose I thought she would no matter what, but you seemed to be open to my winning you over."

"Well, you didn't have to try too hard, darling. Why wouldn't I love my brother's scandalous Yankee girlfriend? Naturally I love _all_ things that unnerve Mama."

"You're very different from her, you know."

Rosamund yipped, grabbing Cora's arm. "Oh — _darling_ — thank you. The sweetest words I could ever hope to hear."

Cora smirked, "I rather think Mary's more like Violet than either Robert or myself. Perhaps it's just because she's the oldest but —" she sighed, "I often worry that she thinks me unbearably America. I don't think our sensibilities align."

"You're much too hard on yourself, Cora. By now the only time your _Americanness _blasts through is at the holidays and even then we're all too tipsy to care, if we notice at all."

"That's reassuring."

"You're right, though. She is a bit. . . _predatory_." she chuckled a bit, "And what about little Sybil, hasn't she turned out to be a bit of a rebel without a cause?"

"I think she feels she's got _plenty _of cause," Cora laughed. "You should come for dinner tomorrow night — I'm sure she'd love to see you."

"I think I will." Rosamund said, "Oh — and poor Edith. We always forget about her. I guess it's because she's such a good girl."

"Well, I'm glad to hear you say it. I admit when she told me she was working on your unit I was a bit apprehensive."

"For her or me?"

"Both, I suppose."

"I'm tough but I'm _fair,_ darling."

"Oh, I know. Edith's just very sensitive."

"Hmm." Rosamund grunted, "I think one day she'll surprise us all."

Cora smiled, "I'm glad you've taken her under your wing. You've always been a very good influence on her."

"Oh, Cor — do you mean that?" Rosamund beamed.

"Yes, of course I do!" Cora laughed, "I mean you were a wonderful Aunt to all three girls but you really took a shine to Edith and I've always been grateful to you for that."

"Being an aunt to them has brought me so much joy. So I think I ought to thank you." she reached over and pet Cora's stomach resolutely, "And look — now I get to do it all over again. Doesn't get any better than that, does it darling?"

* * *

Settling into their usual table in the far flung corner of the hospital's cafeteria, Elsie felt a pang of nerves as she stirred her tea. Dr. Carson had smiled amiably on the walk over, but said nothing. It wasn't altogether unusual for them to lapse into companionable silences, but this seemed different; it wasn't exactly an uncomfortable silence, but one that was heavy with uncertainty. That's what troubled her the most about it; that how she'd treated him earlier, her frayed nerves fizzling out in his presence, had hurt him in some way. Though what _had _he been thinking, reaching over and touching her so freely like that? They were colleagues and friends but —

She bit her lip, watching her tea whirl around in its paper cup, a small milky galaxy. Even if Beryl was right and he — had ever, at any point, had _those _feelings for her — why _now_? Several decades had passed them by since she'd been in _her _prime. His window for flirtation, for lingering dinners and inviting her to his flat — those years had passed so why _now _would he reach for her?

"Liddy is looking better." he said, his voice booming across the table. She jumped, the sound knocking her back into consciousness. He looked up at her peculiarly, but ignored whatever fleeting confusion had rippled across her face. He was always courteous in _that _regard. "Were you able to confirm enterovirus?"

Elsie sighed, "She's responded well to the treatment — still waiting on the labs. I worry, though, she's still a bit floppy in the limbs. I do hope she'll not have permanent damage or partial paralysis."

"Has that been the prognosis?" he set his cup down, "I know in the literature I reviewed there were several American children who had lasting paralysis, which they've still not gotten to the bottom of."

Elsie sipped her tea, humming against her cup in agreement. She swallowed and nodded, "Yes — well, that's what I'm afraid of."

"She was happily kicking her legs at me earlier," he said, unable — or unbothered — to hide the sweet grin that graced his face. Elsie studied it a moment; the sight of it made her smile, too.

"When you were singing Dean Martin to her?"

Charles blushed, "So you heard a bit of that then."

"I did — you've a lovely singing voice, Dr. Carson. You ought to consider joining the interns for karaoke at the pub on Friday nights."

"_Good God_," Charles groaned, "I'd rather have an unanesthetized sternotomy."

"What's put you off it? The pub or the _youths?"_

"Neither—" he chuckled, "The horrible selection of tunes at those things." he puffed out his chest playfully, "Dr. Hughes, God did not give me this emotive baritone so that I could down a few neat vodkas and sing _Total Eclipse of the Heart."_

"I'd pay good money to see _that._"

"Well — save your pennies for retirement, Dr. Hughes because it'll never happen." he reached for his tea and noticed that his last remark seemed to sting; and only then did he realize why. "Oh, I was only being facetious — it was a thoughtless remark, I'm terribly sorry —"

"It's fine, Dr. Carson. Really, you needn't apologize." her voice was tentative and suddenly she felt miles away from him, despite the fact that if he was different — _if things between them were different_ — he could have reached across the table and taken her hand.

"I was thinking about what you shared with me and — well, I wanted to say that I admire you." she flicked her eyes up at him, seeming to be genuine surprised by his remark. "I mean it — I — _well,_ you've had rather a rough go of it and all these years, we've worked side by side and I never knew. I've only ever known you as a brilliant, capable, kind physician — easily one of the best I've ever had the privilege of calling a colleague and —" he paused, his voice grown quieter, "— and a _friend. _I just think that you should know that — well, though you've clearly had your struggles, and I suppose we all do to some degree, but you certainly had a responsibility that many of us do not — well, what I'm trying to say is, if your aim was to perform so expertly that no one knew how frightened you were, or how unsure you were at times — well, you certainly had _me_ fooled."

"I wasn't trying to fool you," she whispered, her voice thick with emotion and milky tea.

"Oh — oh, Dr. Hughes I know that. I mean, I wouldn't have thought so it's just — I suppose what I'm trying to say is that if you've been worrying all these years that you would come across as incompetent in any way, or that your work would suffer — that your professional life would be adversely affected by the challenges in your personal life — well, I just want to assure you that it h_never_ as and, frankly, I don't think it ever _could._" he locked his gaze on hers, his heart beating wildly in his chest at doing so — she had beautiful eyes and as the late afternoon sun began to hover at the horizon, it shone in through the window and gave her eyes a precious glint that warmed him.

After a moment she lowered her gaze, heat rushing to her face. "You flatter me, Dr. Carson. . ."

He felt her preparing to brush off his sentiments and he wouldn't have it — not now, not today, not with that he knew and what he _thought _he knew. "Yes, I do." he said firmly. She looked up at him, her eyes wide and lips slightly parted. "And it's a privilege that I do not take lightly."

"A privilege of _what,_ exactly?" she whispered, pulling her bottom lip under her front teeth.

He cocked his head, wondering what answer she wanted. He knew at once what he meant to say, but he was so aware now of how easily he could hurt her, how loving her this much — knowing her this deeply — gave him that power and it was more than he could wrangle, making him clumsy and the hurt was unintentional but it happened and he loathed it. His surgeon's hands could made the finest of healing cuts, snip out the damage, lace up and set straight — but they couldn't seem to keep from squeezing her heart too tightly, letting it slip from his grasp.

"Of — of our —" he stuttered. She watched him, her eyes widening. "We've known one another a very long time, Dr. Hughes. I would hope that . . .that _amount of time_ . . .shared between us would have bred some . . .um, well, some _trust?_"

She sighed, "It _has_ been an awfully long time, hasn't it?"

Charles laughed nervously, "You know, sometimes I forget. I forget that we're not young." he cleared his throat, "That_ I'm_ not — that, that _none of us_ are."

Elsie giggled, shaking her head at his stumbling, "You make it sound as if we're a couple of ancient old _trouts._"

"You don't feel as though you are?" he asked earnestly, "_I_ do. My hands aren't what they used to be. I've gone gray at the temples. I've got a shoulder that aches whenever it rains." he sighed, reaching up to run a hand along his neck. "Don't you find yourself getting run down more easily?"

She narrowed her eyes at him, growing suspicious of the conversation's direction. "I don't know, Dr. Carson — do _you_ think I've slowed down?"

"I — well, _no, _it's just — I mean, we're both older now and things — things can change for us and — there are things that can impact our health in — in various and sundry ways and —"

"Who've you been speaking with?"

"What?"

"What are you nattering on about this for?"

"Dr. Hughes, I'm only ruminating — just making friendly conversation. Why would you think that I have ulterior motives?"

Before she had a chance to respond — not that she has even formulated a response yet — her pager buzzed in her pocket and she reached for it eagerly.

"I'm sorry — I've got to take this. Thank you for the tea and — and the _chat_, Dr. Carson."

"Wait," he said, holding a hand up. She was halfway between sitting and standing, and while he'd hoped she'd opt to lower herself back down into the chair, she did not. Instead she straightened her back and looked down at him, fist curled impatiently against her hip.

"Yes?"

He wasn't even sure what he wanted to say — he just didn't want her to leave in anger. He saw her eyes flick up to the doorway, and he was losing her and he felt it, felt her slipping from his hands once again.

"Earlier, when I left that note in your office — I was searching for a scrap of paper on your desk and — I saw the letter from Dr. Clarkson."

The color drained from her face, "You went through my private correspondence?"

"No —_ no,_ I most certainly did _not._ Not _intentionally._ I — I was trying to get the _Post Its _and, well, that stack of paper toppled over and I tried to fix it —"

"And you read the letter?"

"I was merely picking it up and trying to — trying to reorganize the chaos of your desk."

"But you _read it, _Dr. Carson, is that what you're trying to say?"

"Not so much that I read it but — but I saw that — I _saw_ the words and —"

"Seeing the words — well, that implies that you _read it, _Dr. Carson." her voice was rising and wild, and she shook her head, looking at him with something close to hatred, "So, just what do you think you gleaned from _seeing those words_?"

He swallowed, "I'm beginning to understand why you've been so on edge today."

She laughed bitterly, "_Well,_ Dr. Carson, might I remind you that it's not your_ job_ to understand_ anything_ about me."

"I disagree!" he snapped, standing suddenly, towering over her. "You are an esteemed colleague, _a friend_ and —" he exhaled sharply, "And someone whose well being I happen to _care_ about!" he could feel adrenaline coursing through him and he spoke quickly, "Dr. Hughes, I will be _entirely_ forthright: I am very hurt that you would keep something like that from me. After all these years I would have hoped that you trusted me, felt that you could_ confide_ in me — and know that you could do so in confidence. But now I am beginning to think that I have perhaps invested far more into this than you and I admit — I feel rather a fool."

She was completely dumbfounded by his admission and before she could respond, her pager bleeped again and though she had no intention of reaching for it, he huffed, turning away and set out across the cafeteria. The space before her that he had just occupied felt suddenly cold as she stepped into it, making her way back to pediatrics in something of a haze. She'd been so concerned with keeping her own secrets that it never occurred to her that she herself might be one.

* * *

"Here," Thomas said, handing his lighter to Sarah as they leaned up against the brick wall outside the ambulance bay. She popped a cigarette into her mouth and accepted his lighter, flicking it and greedily inhaling.

"I've got long enough for about three drags off this before they'll notice I've skipped out," she said, exhaling a plume of smoke, "What was so _bloody_ good that you couldn't just phone the desk?"

Thomas gave her a sly grin, his cigarette bobbing against his lips. "I think the universe is conspiring against Dr. Hughes right alongside us," he said cryptically, reaching up to pluck the cigarette from his mouth. "I think we oughta lay off her a while."

At this, Sarah chortled. "_Jesus_ — you're making it sound like she's_ dying_."

Thomas pitched his cigarette butt onto the ground, grinding it into the pavement with the toe of his shoes.

"Oh, _fuck._" Sarah said under her breath, "_Wot_ — cancer? Parkinson's?"

"Don't know yet — abnormal mammogram. Dr. Clarkson's scheduled her for a core needle biopsy next week."

"I'll be damned." Sarah said, lifting her foot up so she could stub out the half-smoked cigarette against the bottom of her shoe. She handed it back to Thomas and he pocketed it. "I guess we'll wait and see what happens — that your plan?"

Thomas nodded, stuffing his hands in his pockets. "Life's fucking her harder than _we_ ever could. We might as well direct our efforts _elsewhere_."


	16. Ultraviolet

Though he'd spent the better part of the night deliberating on the subject, Charles didn't know quite what he was going to do until he found himself standing before Robert Crawley's office door bright and early Friday morning. He hesitated before knocking.

He'd not been able to stop thinking about it since he set foot in his flat after work the night before. He thought of it while he angrily chopped vegetables for his supper, while he had a drink — and then another — as he watched the late news broadcast. He lay awake in bed, tossing and turning, her voice echoing in his memory; _it's not your job to understand anything about me. _

That was _precisely _the point, he decided, raising his hand to knock on the door he stood before now: it _wasn't _his job, it _wasn't_ something that he did out of duty or fiscally necessity or even intellectual satisfaction. He didn't _have_ to do it at all; it merely _was_. It was part of him — of them. Or so he'd thought, though he'd awoken this morning feeling anxious and, of all things, sheepish.

When he stepped into Robert's office he was surprised to see Cora. Not only was it rather early — just after six thirty — but Robert's wife rarely made an appearance unless something was amiss or there was some gala to attend. Not that he minded, particularly. He rather liked Cora; always danced with her at least once at the hospital gala, always asked after the girls.

"Dr. Carson!" she said brightly, rising from her chair and crossing the room to embrace him warmly. "What a treat to see you!"

"I'm sorry if I've interrupted—" he said, looking over her shoulder at Robert.

"No, no — not at all. Come in, have a seat." Robert said, gesturing to the couch. Cora brought Charles to it and sat down next to him, patting his thigh excitedly.

"I feel as though I never see you except for the gala, Carson." she said, feigning a small pout. "You're well? Things are going well in the department?"

Charles nodded, "Yes — yes, very well." he said absently, "And things are well with you?"

She smiled — appearing almost to do so in spite of herself. "Yes. Very." she blinked, turning to look at Robert, "Sybil will be home from college on holiday — her flight will be in this afternoon."

_Aha_, Charles thought. _They must be making arrangements on that matter. Nothing terrible. _He relaxed a bit.

"What brings you in at this early hour?" Robert said, leaning back in his chair. He seemed almost too casual for the conversation Charles wanted to have, but he couldn't well turn back now.

"I'm — well, I have something on my mind." he said nervously. Cora's face fell.

"Oh — I can step out if you'd rather have this conversation without me —"

"No, no — you can stay. I think perhaps I'd prefer it."

"Carson?" Robert said, leaning in, his face grown stoney. "What's happened?"

"Well, nothing yet — but —" he sighed. "Well, it's not to do with _me_, exactly. But —" he turn to Cora, who was looking at him with nearly a pained expression. For a fleeting moment he noticed that her face was almost peculiarly aglow, but he left it. "It's about Dr. Hughes."

Robert nodded slowly, "You've . . .had a disagreement of some kind?" he ventured.

"No — well, I mean, I suppose we have — and if she knew I were here she would never forgive me." He knew this was true. Cora looked up at him sympathetically; she knew it too.

"What's happened?" she said quietly, leaning in a bit.

"She _may_ be unwell. She's had — well, she's had a test. Or a few, I'm not sure. She's been scheduled for more and I suppose she'll know soon enough but —" he looked up at Robert pleadingly, "As I said, if she knew I'd said anything not only would she be _livid_ but I'm sure there would be question of her privacy. I just think that you should — be aware that — well, things may be difficult in the coming weeks and perhaps she'll need — all of our kindness and —" he let his gaze fall to his lap, wringing his hands nervously, "_understanding_."

"We'll not betray you, Dr. Carson." Robert said, sighing wearily. "I do hope it doesn't turn out to be anything serious." he smiled sadly, "As much as I like to think I preside over this hospital, I know that it's the two of _you _who really run things. Without either of you we'd be entirely lost."

Charles opened his mouth to protest, but Cora stopped him.

"Charles Carson don't you act like you don't know damn well it's the truth." she said, admonishingly him with a smile. She looked up at the clock and then to Robert, "Darling, I'm going to step out for a moment and get a cup of tea —" she turned back to Charles, putting her hand on his shoulder, "Thank you."

"Take care, Cora. Always a pleasure to see you." he said, patting her hand.

She crossed the room and kissed Robert on the cheek — lingering a moment at his side, then she stepped out, quietly shutting the door behind her. After a moment to collect his thoughts, Robert folded his hands atop his desk and eyed Charles.

"It's none of my business but in light of all this —" he tapped his thumb against the other, laughing a bit, "Is there or — has there ever _been_ — anything between the two of you?"

Charles blinked, "No — no, no, I can assure you not. I'm not one to fraternize."

Robert shrugged, leaning back into his chair. "Oh," he said, his voice almost tinged with disappointment, "That's rather a shame, don't you think?"

* * *

Cora made her way down the long halls of the hospital toward pediatrics. She was glad to note that she had to double back, having missed the door. She was fortunate to have not been there often in her life; her girls had been healthy, thankfully, and so the unit that Elsie Hughes ran was not one that she'd any reason to frequent. She rounded the corner and all was quiet and dark; most of the patients were still asleep. The first shift staff drowsily nursed coffees as they flipped open charts and tapped syringes. She lightened her steps so that her heels wouldn't break through anyone's slumber and saw that Dr Hughes' door was cracked open. She rapped on it lightly and pushed it open.

She must have only _just_ gotten in; she hadn't even removed her coat. She looked up and seemed startled to see Cora standing there.

"I'm sorry to just burst in – especially right at the start to your day." Cora said.

Elsie straightened, slinging her purse into an open chair. She shrugged off her coat and draped it over her arm. "No — it's fine but —" she laughed, "You're about the last person I'd expect to see first thing on a Friday morning."

Cora smiled, taking a few steps toward her. "Well, I wanted to just speak to you briefly."

"The girls are fine, I hope?" Elsie said, gesturing for Cora to sit. They did, Elsie behind her desk and Cora in the chair that held Elsie's bag.

"Oh yes. Well, you'd probably know better than I do. I think you see them more."

Elsie smiled; it was true, she probably did.

"I actually just wanted to say that —" Cora began, but she faltered. Only now that she was sitting across from Dr. Hughes did she realize she wasn't sure that she knew precisely what she meant to say. "I just wanted to take a moment, since I happened to be on campus today, to let you know that. . .that Robert and I both think very highly of you and we respect your work immensely. You are, truly, the very heartbeat of this hospital and —" she blinked, "Well, if there was ever _anything_ that you needed — from us, from the hospital, from the board even — we hope that you'd let us know."

Elsie looked a bit stricken, "Well — thank you?"

"If — if you need anything at all, Dr. Hughes, you should know that Downton will take care of you. Robert and I would personally see to it that you have whatever you need. If you need time, our resources, our connections — specialists or clinical trials —" she knew she'd stepped too far but she couldn't go back on it now, the words just flew out of her mouth, "We _will _take care of you, Dr. Hughes. You won't have to worry about anything. Whatever it is that you need, we will look after you and see that you receive the best care."

"I don't know what to say," Elsie said, tears filling her eyes. "Except — except for _thank you,_ I suppose."

Cora didn't expect the doctor to offer any more on the subject, but feeling that she'd been heard, she merely reached a hand across Elsie's desk and took hers, grasping it reassuringly. After a moment, she stood to leave.

"You don't have to worry, Dr. Hughes." she said quietly, "Downton will always take care of you."

* * *

Hoisting her carry-on into the overhead compartment, Sybil sighed audibly. At least she had a seat to herself —or so it appeared. She'd figured out that if she reserved the seat near the emergency exit not only was it usually equipped with more legroom but hardly anyone else ever joined her. She always got a few odd looks at the gate. The airport staff would run through there spiel about the responsibilities of sitting in the emergency exit row, and she'd nod politely. Truth be told she was probably better off sitting there than most; all the medical knowledge she'd accrued and her sprite youth set her up to be heroic, if required.

She settled into her seat and plugged her earbuds into her phone. It wasn't a long flight, really, but it was long enough that she could take in a podcast or two, or listen through Joni Mitchell's discography — her usual soundtrack for flying.

Her phone buzzed in her hand, reminding her that she'd not, in fact, put it on _airplane mode_. It was a text from Tom. Her heart fluttered as she tapped the screen.

TOM: (_7:31 AM_)

Still picking you up at the airport at 1? Really looking forward to seeing you :)

SYBIL: (_7:33 AM_)

Yep! :) Thanks again. I just boarded so will be taking off soon! Looking forward to seeing you too! 3

"We'll be taking off in a minute, love."

Sybil looked up at the flight attendant, who couldn't have been much older than Mary. She was being very nicely admonished and she couldn't even be angry.

"Pocketing it now," Sybil grinned, her cheeks pink.

"Boyfriend nagging you about when your flight will get in?" the flight attendant laughed, "Well, you've got a minute, text him back and tell him we're right on schedule."

Sybil giggled and the flight attendant gave her a wink before she moved on down the aisle.

SYBIL: (_7:34 AM_)

The flight attendant thinks you're my bf ;)

TOM: (_7:35 AM_)

What airline are you taking?! _ Air_? When you get to Heathrow are you going to have to look at all the terminals and choose the one with the cutest guy waiting on the other side?

The plane taxied ahead and rumbled beneath her – she shot off one final text, not sure if it would make it across the airwaves before she lost service. Of course, she hoped it did:

SYBIL: (_7:35 AM_)

The guy picking me up in an ambulance will win every time.

* * *

"Cora Crawley?"

Cora looked up as the young radiology assistant called her name.

"Come on back."

They walked down the corridor and the young woman handed Cora a key, directing her toward a small closet where a folded johnny awaited her.

"Toss your bag and clothes into that locker, lock it up — throw that johnny on and come on into the exam room."

"Thank you," Cora said, taking the key from the girl.

"I'm Ethel, by the way." the girl smiled. Cora nodded, then noticed that the young woman — who couldn't be that much older than Sybil, was visibly pregnant. She wasn't much taller than Sybil either, and couldn't have been more than 110 lbs sopping wet. Cora smiled; the little belly under her scrubs was adorable. Years and three prior pregnancies had stolen any of that cute, young pertness from _her _body and she knew her days of having a cute, _tiny _bump were all but behind her.

"How far along are you?" Cora asked as Ethel turned to go.

"Oh!" the girl said, smiling, almost surprised to have been noticed. "Six months!"

Cora's eyes widened, "_Six_? You're still so tiny!"

Ethel blushed, "Well, my doctor said I was so tiny to begin with — you know, I'm all belly really."

Cora nodded; once she'd been the same.

Ethel closed the door and Cora moved to undress, folding her clothes and placing them neatly in the cubby. She pulled the johnny on and tied it twice around her waist; they were always about three sizes too big and slipped precariously off her shoulders. Stepping out, johnny dutifully donned, she padded down the hall, sliding on the linoleum in her socked feet as she turned into the exam room.

"Hop on up!" Ethel said, patting the exam table, the paper crinkling under her hand.

"Can we wait for just another moment?" Cora said, laying back against the table, "My husband is on his way down."

"Oh, sure thing." Ethel said. "First?"

Cora laughed, "No, no. This will be number _four_. I've got three girls! One short of casting _Little Women._" She turned her head toward the door at the sound of a soft knock.

"That must be Dad," Ethel said, moving to open it. Robert came in, a bit flustered.

"Hello darling," he said, coming to Cora's side and leaning down to kiss her forehead.

"Hi," she said quietly, noting how nervous he looked. The truth was, even though it was their fourth child this was the first time he was present for an ultrasound. With Mary, they just hadn't been done all that frequently, and with Edith and Sybil he'd always been too busy — twenty minute appointments were far too long to fit into his day.

Ethel lifted Cora's johnny, draping her lower half and squeezing the clear gel against the skin of her belly.

"Oh! It's _warm_!" Cora marveled, she turned her head up at Robert, who took her hand, kissing her fingers gently. "I remember it being cold. . ."

"They have warmers for it now!" Ethel laughed, she eyed Robert, trying to figure out where she knew him from. It wasn't unusual for the C-Suite to so rarely enter certain departments that lower staff could work in a hospital for decades and not know the CEO from Adam. She pressed the wand against Cora's abdomen and turned the screen toward her.

"When will we be able to tell if it's a boy or a girl?" Robert said, squinting at the gray screen.

"It's a _little_ early yet." Ethel said, "Looks like you're just starting your second trimester, Cora."

"What am I supposed to be seeing?" Robert whispered, leaning down close to Cora's ear. She hushed him and pointed a long finger toward the screen.

"See —" she breathed, "That's the head — and that's the little nose—"

Robert squinted harder and when the picture fully came into view and he got his bearings looking at it, he hopped excitedly, bringing Cora's hand to his chest. "Oh! Look at that!" he said, "A hand? Is that a hand — or — a foot?"

"That's a hand," Ethel giggled, "Giving a wave!"

Ethel shifted the wand, making notes along the screen to indicate the baby's size and position, and after a moment, she paused, looking at Cora with a little grin.

"Well — the baby's in the right position to tell you the gender."

Cora's eyes widened, "Oh!" she turned to Robert, "You want to know, right?"

"Yes, yes of course." Robert said, looking up at Ethel.

Turning back to the screen, Ethel pressed the wand gently against Cora's abdomen and made a small circle with her cursor on the screen.

"Looks like you won't be able to reenact _Little Women _after all." she laughed, "It's a boy!"

Robert made no attempt to hide the flood of tears that gripped him. As he turned to look at Cora, he saw that she too had teared up, wrapping her fingers more tightly around his hand. He leaned down to kiss her, running a hand along her hair. "A son," he said softly, "I'm going to have _a son_."

* * *

"I don't know, I think it's kind of nice he's worrying after you." Beryl shrugged, popping the lid off her coffee mug as she and Elsie sat in the still-empty nurses' station. It was early yet and the patients had only just begun to be woken for morning vitals, the breakfast cart teetered down the hall in the distance — Anna and Phyllis had bustled by in their civvies*, headed for the lockers to change into their scrubs and throw their hair up in ponytails or loose buns.

"I don't want _anyone_ worried about _anything _— _least _of all _me _and _least _of all by _him!_"

"You know he didn't go looking for that paper," Beryl said, "It's your own damn fault for leaving it out on your desk."

"In the privacy of my own office?"

"You know he's in and out, as am I —" she gave her a knowing look, "Maybe you wanted him to find it. Maybe it was a subconscious lapse."

"Don't be ridiculous." Elsie sighed, "It doesn't matter now. If the _Crawleys_ know sure enough everyone else will soon."

"Who do you think told them?"

"They probably found out on their own — it's not like Robert doesn't lord over this place. I just wouldn't have thought in a million years he'd send his _wife_ in to calm me down."

"Did you ever consider that she came to see you because she _cares_? Because _they _care? Because _everyone_ in this damned hospital cares?" Beryl heaved a frustrated sigh, "Why is it so hard for you to accept that people care about you? That they want to support you and help—"

"Because I don't even know that I need any help, I don't know if anything's actually _wrong._ There's no point in getting everyone riled up over nothing is there?"

"Elsie, _that's_ the point. This is the part where you do need people to support you. The _not knowing_ is hard — you know that. How many times have you told a family to stick together while they wait for a diagnosis? You know better than anyone how scary this is."

She paused. Elsie stared into her coffee cup, unspeaking.

"Have you really spent all these years around us — around the Crawleys, me, Anna — _Dr. Carson_— and thought that we were all indifferent to you?"

Elsie looked up not sure how to respond, but Beryl took her hesitation as an answer.

"_Els_," she said, shaking her head sadly. "Now I feel like I should have worried about you more."

"It wasn't your job."

"_For the love of Chris_t, Elsie! You're my friend and I _bloody _care about you. I hate to think that we've been friends all these years and — and you didn't _know_ that." Elsie didn't speak, just snapped the lid back onto her coffee mug. Beryl sighed, rubbing her eyes on the heel of her hands. "If I feel this bad, I can only _imagine_ how Dr. Carson feels." she brought her hand around and rested her chin on it, hiding her mouth as she spoke low, "Poor man's probably heartbroken."

* * *

"I can't believe we're doing this," Cora whispered, her lips pressed against Robert's neck. He pulled her closer, wrapping his arms around her and pushing his swivel chair back from his desk. "The last time we did this — _God_!" she laughed, struggling to unbutton his shirt.

"We won't have a spare moment tonight, not with everyone coming for dinner." he said, trying to catch his breath, "Besides, even if we did — I don't _want_ to wait." He ran his hands over her hips, pulling her harder against his lap. She purred, tipping her head down to kiss him.

"Dad, what time should I—"

The both startled at the voice booming from the doorway. Cora turned to look over her shoulder, her hair falling across her eyes.

"OH GOD OH GOD I AM SO — _OH MY GOD_." Edith said, covering her eyes and turning on her heels, attempting to find her way back to the door, but running straight into an end table, stumbling forward.

"Edith — oh, _fuck._" Cora said, lifting herself from Robert's lap, reaching up to tidy her blouse, which was half undone.

"Did you just say —?" Robert laughed, running a hand along her waist as if Edith wasn't, still, struggling to escape the room just a few feet away.

"Yes, I did! 'Cora said sharply, fumbling with the buttons of her blouse and moving quickly across the room toward the open door, losing a shoe in the process. "Edith, _wait_! Darling!"

Sighing, Robert stood and crossed the room, picking up the loafer Cora had left in her wake.

"Bloody Cinderella, isn't she?"

He looked up to see Rosamond leaning against the doorframe, a satisfied smirk on her lips.

"How much of that did you —?"

"Enough to be assured of that you still love your girl after all these years,_ Robbie._" she said, reaching up to pat his cheek with sisterly condescension. "So," Rosamund said, clapping her hands together, "What time's dinner? Should I bring a bottle of red?"

Robert groaned, "Something a little _stronger_, I think."

* * *

Donning her glasses, Elsie stared at the MRI lit up before her in the darkness of the radiologist's office.

"It will need to be biopsied but looks like a pretty standard astrocytoma to me." Dr. Anstruthers said, "How old is the patient?"

"College girl, maybe 22?."

"A bit older than average but they _are_ a slow-growing tumor. She's probably had it for years."

Elsie hummed thoughtfully, looking down at her notes. "It's benign?"

"Yes," Dr. Anstruthers said, pulling the film from its mount on the wall and replacing it with another, slightly different view. "Though positionally it could be problematic for reasons that aren't related to cancer."

"Could it explain her abrupt personality change? The fugue?"

Dr. Anstruthers folded her arms across her chest and shrugged, "It could — you'll really want to consult with the pediatric neurosurgeon. Isn't Crawley hiring another one? I heard she's some young thing, London girl. Name's Swire? Father's some big wig attorney."

"Hm. That's the second time I've heard her name. I suppose I should do my research. She'll certainly be on my radar if she's in pedes."

"They keep getting younger and younger," Dr. Anstruthers said ruefully. "I can't believe I'm walking the halls with the Crawley girls — as doctors, they're _doctors. _And that new one — the other Crawley, Matthew?" she bit her lip, giving Elsie a playful little shudder of delight, "He's dishy — have you had a proper look at him?"

Elsie rolled her eyes, "I think he's a little _young_ for me to be gawking at."

Dr. Anstruthers guffawed, giving Elsie a light slap on the arm, "Oh, that's right I forgot — you're spoken for. _Crumdrudgony_ Dr. Carson."

"What? Oh — Oh, no no. He's a colleague. An old friend."

"Oh, please — I've been in those meetings with you two. The minute you walk into a room his old sour mug lights up like a bloody Christmas tree."

Elsie blinked, staring at her blankly.

"Are you telling me that there's not — that there's never _been_ — a little something between you two?"

"No," Elsie said, shaking her head almost apologetically. "Really, there isn't."

"_Well,_" Dr. Anstruthers said, putting a hand on her hip definitely, "You had me fooled." Elsie lowered her gaze almost sheepishly, searching her pockets for a pen, anything to busy herself. Dr. Anstruthers lowered her chin, looking up and finding Elsie's eyes. "I think maybe you've fooled _yourself_ into thinking there's nothing there. But mark my words, Dr. Hughes, that man's only got eyes for you. And if you say jump he'll say, _onto your bed — or mine?_"

* * *

"I wish I could just go on a ride along with you and _not _go home to a houseful of Crawleys." Sybil moaned, letting her eyes flutter closed as she pressed her feet against the dashboard of Tom's rig. "I'm bloody knackered and the last thing I want is to hear anything about the hospital, or my sisters successes."

"Just tell them you're so damned excited to volunteer at the hospital over break that you've just got to start tonight. Your grandmother would probably explode with pride."

"I do want to see my mum, though. I miss her. I think she's the only person in the whole family who actually gets me."

"Your mum's a nice lady," Tom said, "You look like her."

"Yeah?"

"Yeah. Pretty ladies, the Crawleys are."

"Smooth. Complimenting my looks and my mums in the same breath. You know how to make the panties drop, don't you Branson?"

Tom laughed nervously, "Well — I just —"

"I'm teasing you, relax." Sybil said, shaking her head. "You're pretty cute yourself."

"Yeah?"

"Yeah."

There was a pause; beneath them the ambulance's engine revved, blinker clicking as he turned into the Crawley's long, stately drive.

"I think we could be adorable together. You know, like, in public. You should ask me out for a drink sometime." Sybil said, giving him a sidelong glance. He put the rig in park and looked at her a bit in awe. He moved to unbuckle, help her with her bags, but no sooner had he reached down then he saw a league of Crawleys exit the front door and make their way toward him, waving wildly.

Hopping out of the rig, Sybil slung her backpack over her shoulder and turned to look at him, her eyelashes fluttering prettily against her flushed cheeks. "Thanks for the lift."

"Anytime," he stuttered. "Sybil?"

"Yeah, Branson?"

"Wanna grab a pint sometime?"

* * *

Every Friday night Charles Carson allowed himself one tiny deviation from his normal routine: he had a glass of sherry. He' sip on it while he puttered around the kitchen, throwing together some standard fare for dinner before settling in to catch the world news report. He'd not felt like anything much, his stomach still in knots over his — what had it been, a disagreement? A row? — with Dr. Hughes. He thought perhaps he'd permit himself a second glass of sherry; anything to lubricate the grating nerves that buzzed in him. So on edge he was that when there was a sharp rap at his front door, he dropped the fork he'd been holding and it went clattering across the floor.

"Yes — just a moment!" he called out, bending down to pick up the utensil as well as the leaves of lettuce that had been strewn about the floor. He straightened up, brushing back a few unruly strands of hair from his eyes and wondered who could possibly be at the door. It was nearly seven o'clock. Surely that was too late for salespersons.

When he opened the door and saw her standing before him, a bit damp from the cold and wet turn the evening had taken, he couldn't have been more flustered. Fork still in hand he stood, mouth agape, in the doorway.

"Dr. Hughes," he blinked, "I—" he wasn't even sure what he wanted to ask first. He hadn't even realized she knew where his flat _was. _

"I'm sorry to disturb you, Dr. Carson." she said, her voice hoarse from the cool night air, "May I come in?"

He swallowed, stepping aside hurriedly, "Yes — yes, of course. Come in." He closed the door behind her and scanned the floor for more rogue pieces of lettuce. "Please excuse the state of things. It's rather a tip, I know."

Elsie looked about, getting her bearings. His home could hardly be described as a mess. If anything the pathological order of things was more concerning than if he lived in the true sty of a bachelor.

"Has something happened?" he said, setting the fork down in the sink and turning momentarily to the stove, covering the pot of pasta and turning the heat back.

"Well — no, I mean, _yes. _Something has — or, _did_." she looked around for a place to sit. He watched her a moment and realize she still had her coat on.

"Oh, Dr Hughes I'm terribly sorry. Let me take your coat." he said, bustling to the table. She slid it off her shoulders and handed it to him, taking her cue to sit at the small kitchen table. She looked down at the worn wood and realized that he'd only ever sat at one end of it, she could see the scratches on one end, the discoloration in the wood.

The spot opposite her was pristine; unoccupied in perpetuity.

"Dr. Carson, I wanted to apologize for what happened earlier—"

"No, _I_ should apologize. I should not have read that report."

"It wasn't really your fault. I know you didn't go_ looking_ for it."

"I should _never _have gotten into the habit of dropping into your office like that. It's an invasion of your private workspace and it's inappropriate. I shouldn't take liberties of anyone but least of all you."

She sighed. She wanted him to listen but knew he wouldn't until he'd exhausted his apologies. Until he felt he'd repented.

"It's forgiven, Dr. Carson." she said quietly, "But I was unnecessarily cold and — _mean,_ really. I wanted to apologize. I know that you — that you were speaking from kindness and I shouldn't have jumped on you and assumed otherwise."

There was a pause before Charles moved to the table, easing himself into the chair opposite her, the ever-empty one. He seemed immediately uncomfortable, out of place, as if he'd never seen the room from that vantage point before.

"I — I'm _uncomfortable_ when we disagree." he said shyly, "I — I don't just mean on a case, on work related thoughts — but — I don't like it when we aren't in agreement."

She bit her bottom lip, her face flushing prettily.

"Dr. Hughes we've known one another for so many years and yet — I'm realizing that I don't really know you_ at all._ I've confused time spent working parallel to some kind of friendship or —" his breath hitched, "—_intimacy_, I suppose."

"I don't think you've confused it so much as I've denied it, Dr. Carson." she said quietly, "I think, perhaps, I've made it very difficult for you — or _anyone_ — to _be_ my friend."

He was quite stricken not just be her honesty, but her self-awareness. She was guarded, and he'd always assumed it was intentional, methodically planned. Perhaps not.

"I wouldn't say _difficult_," he offered, "but you don't suffer fools gladly."

She gave a small laugh, "No, I suppose not."

"And I've been, at times, a fool."

"Dr. Carson, I came here to make amends — not make you feel as though you owe _me _any kind of apology."

He blinked, pressing his palm against the table, swiping away nonexistent crumbs. "I shouldn't have pried into your personal life."

"You only asked because you care, Dr. Carson. I'm sorry I didn't understand that."

He looked up at her, her gaze fallen softly. He might have imagined it, but he thought he saw her eyes flick down to look at his lips a moment. He cleared his throat uneasily.

"I have never been one express my emotions well, Dr. Hughes. It's entirely possible I didn't show you —"

"Dr. Carson," Elsie said, her voice a bit stronger. "You did. You _have_. I'm only sorry it's taken me so long to — to understand that. To acknowledge it." she sighed wearily, "It pains me to think how inadequately I've reciprocated. I don't think I've — perhaps _ever_ — conveyed to you how much I — _well, _appreciate our — relationship." she bristled, "Our _working _relationship, you know, we — we _work_ well together."

He waited a moment then smiled slowly, "I agree, Dr. Hughes." he sighed, turning to look toward the stove. He could hear the pot of pasta; all but boiled away to steam. "May I offer you a glass of sherry?" he said standing, returning to the counter where his glass awaited him. He turned back to her quickly, "Unless you're on call?"

She laughed lightly, "I'm not on call, for once! If it's no trouble I think perhaps I _would_ like a glass."

"Oh, no trouble at all. I would be pleased to share it with you." he said, crossing the kitchen to his small liquor cabinet, "I'm quite proud to have this, actually — it's a rather rare sherry, only about 100,000 bottles sold in a year. Now, I understand it may not be to your liking. It's a _palo cortado_. In fact, this sherry is most often produced entirely by accident while making _fino_" he reached for a glass and poured slowly, "It's a most beautiful, _delectable_ little accident."

He rejoined her at the table, nudging the glass toward her.

"Thank you," she said, raising the glass to her lips. Taking a sip, he watched her intently, seeing her eyes brighten as the amber pooled in her mouth. "Oh," she said quietly, "That's a nice entrance; _smooth_ but," she thought a moment, then looked up at him, "Almost nutty. _Almondy?"_

He nodded eagerly, "Yes, precisely! It initially feels to be a _gentle_ sherry but there's a bit of a— of _bitter edge_ to it."

Elsie sipped again, smiling above the lip of her glass. "I _resemble_ that remark. . ."

Charles chuckled, "Well, it's a wine after your own heart, Dr. Hughes. While it's rare and, perhaps, not well understood — it's remarkably versatile."

_"Versatile,_" Elsie repeated, the buzz from the sherry warming her cheeks, "Can't say I've ever been defined as such."

"Forgive me, Dr. Hughes. It's the end of a long week, I've already had _one glass_ of this rather potent drink and —" he paused, laughing slightly, "I find myself feeling a bit overwhelmed that you're here."

She blinked, "Oh — Dr. Carson, I'm terribly sorry. I've imposed on your dinner, on your evening. I've apologized, which is really all I came to do, I just didn't want it to go the weekend and a phone call seemed impersonal." she moved to stand but he put a hand out to stop her.

"No, please stay. I'd — I'd like if you stayed, Dr. Hughes. Have you eaten?"

Elsie lowered herself back into the chair, "I haven't — but only because I'm not terribly hungry. You're right that it's been a dreadfully long week."

"I'm finding I haven't much of an appetite either," he said, "But, to enjoy this fine sherry fully I do think we should have a little something," he stood, waggling his eyebrows as he looked down at her, "Will you humor me, have a few pieces of cheese? I've got a block of gouda I'd love to share. Frankly I'd much rather spend the evening in your company than the BBC's. Will you stay for a while?"

She smiled, her gaze softening. "I think I will, Dr. Carson."

* * *

"When you said a friend was picking Sybil at at the airport I _hardly_ expected it to be that Irish ambulance driver." Violet chuckled, sipping her wine.

"Sybil and Branson did ride alongs when she interned in the emergency department last summer, isn't that right?" Cora said, her eyes pleading with Sybil not to make a scene.

"Yes," Sybil said, "I think perhaps I'll join him again over break."

"Oh — I assumed you'd be shadowing your sisters." Violet said, "Or, well, _Mary_ anyway. I can't imagine what you'd glean from following Edith around other than admiring Rosamund's wardrobe."

"_Jesus,_ Mom." Rosamund groaned, "Sybil darling you're _more_ than welcome to join us on psych whenever you please — just don't let _Grammie Violet _follow you or we may have to lock her in."

"Well she's not going to follow _me_ around," Mary said, lifting her wine glass, "I've got far too much to worry about — not only with Matthew Crawley milling about but what is this about a pediatric neurosurgeon? _Squire_?"

"Swire," Robert said, "Lavinia Swire. She's from London."

"What a name," Violet said, "Though it hardly sounds like the name of a physician. A showgirl, perhaps—"

"_Jesus, _Mum!" Rosamund moaned, reaching for the wine, "Robbie, tell me you've got another bottle of this stashed away somewhere."

"We can't have gone through the_ entire_ bottle already—" Violet said, eyeing Cora, "Not all of us are drinking, are we dear?"

Cora blinked, clearing her throat. Rosamund paused in pouring herself another glass of wine and looked up at her, raising her eyebrows.

"Well — no, I—" Cora looked at Robert. There was a moment of oppressive silence and everyone quieted. Even Isis, who sat beneath the table at Robert's feet, had slowed her tail-wagging to a gentle, steady _thump-thumping. _

"Mum?" Edith said quietly, "Are you alright?"

Robert sighed, "I suppose we've got to tell them."

Cora licked her lips contemplatively, "Yes well —" she inhaled, then looked around the table at the curious, vaguely concerned faces of her family looking back at her. "I know it's going to sound impossible but —" she laughed nervously, "I'm pregnant."

"Oh for _fuck's_ sake," Mary said, draining her glass. "That's preposterous."

"Are you sure it's not menopause?" Edith offered, her eyes wide.

"I had the ultrasound this morning," Cora said defensively, "I'm certainly pregnant, second trimester and —" she exhaled a shaky breath, her voice cracking, "It's a _boy." _

Mary looked up sharply, her head turning quickly, eyes dark. Edith smiled uncomfortably, looking to Rosamund for guidance but her aunt had returned her attention to the wine bottle.

"Well," Violet said steadily, breaking the silence, "That's quite a lot to take in."

Mary stood abruptly, leaving the room in a huff. Either disappointed or insulted, Rosamund grabbed her wine glass, doubled back to grab the bottle, and hurried after her. Edith rose sheepishly from the table, giving her mother a kiss on the cheek and offering to go get the dessert plates. Violet excused herself to the ladies room.

Sybil, who hadn't moved or spoken, looked up at her parents and cocked her head slightly, a small snort of a laugh escaping her.

"Holy _shit_," she said breathlessly, "You two still _boff_?"


	17. A Case of the Mondays

**A/N: Hi guys! Sorry this took a while. We've started a new week but fear not, all that happened over the weekend that matters will be revealed. Also. Smut. There's some smut. And more on the way. All my love to Dee for beta'ing and working through the plot with me — hooooweeeee!**

* * *

**_TO: _**_mjcrawley _

**_FROM: _**_sybcrawl _

_**SUBJECT: **?_

_Mary — honestly, what the_ fuck_ is your damage? I know it's kind of a shock that 1) mum and dad are still doing it and 2) that mum could still get pregnant considering I was pretty sure she started menopause like five years ago — but whatevs. Still you had no right to walk out like that and then go the whole weekend not taking any of our calls or texts. Honestly, I'm emailing you at work because tomorrow is Monday and you'll have to check it and so if I don't hear from you I'll know you're fucking ignoring me. _

_It's no secret that you can be a real bitch but I've never understood where you get off being rude to mum. She's done nothing but be supportive of you and I don't know what your problem is with her having another baby but honestly? You're a grown woman and you need to get over yourself. _

_If you didn't already have a plan to apologize you better fucking think of one because all she did all weekend was cry and it wasn't from hormones. I'm only home this week and I was really looking forward to spending time with her and you've gone and ruined it. _

_So thanks for that. _

_You don't even have to tell me what your problem is tbh — idgaf. _

_I've always looked up to you Mary, but lately I've felt like you only want to be part of this family when it means you can get ahead in your job. Being a Crawley def has its perks but the ones you should really give a shit about don't happen in the walls of that fucking hospital. _

_I'm really pissed but I do still love you because you're my fucking sister but sometimes I really, really, really don't get you. _

— _Syb_

Mary sighed, x-ing out of the email without even beginning to draft a response — but as she closed out the browser window, she suddenly felt a pang of guilt. Checking her watch, she saw that she had just ten minutes before she needed to scrub in on her first surgery. She shook her head, reopening her email; her hands hovering over the keys.

_TO: __sybcrawl _

_FROM: __mjcrawley_

_SUBECT: RE: ?_

_Syb,_

_I have to scrub in so I don't have time to respond to this right now. _

_But I wanted to let you know that I did read it. _

— _M_

* * *

"It's Monday morning, Isobel, why do you have such a shit eating grin on your face?" Violet snapped, pushing her tea cup away and staring down at her day planner. Isobel's face fell as she stepped into Violet's office, tea in hand, and hesitated a moment before she slunk into her usual chair.

"I just — I thought you might have some news to share with me. After your dinner with Robert and Cora."

"I suppose you're referring to the baby."

Isobel blinked, "Yes."

"Which you knew about."

"Well, yes. She came into the office and —"

"You didn't think to mention it? Forewarn me?"

"You know I couldn't have. Patient confidentiality."

"Damn all that, Isobel."

"There are no exceptions, Violet. That's _your_ rule!"

"I could have had a _stroke_."

"Don't be so overdramatic," Isobel scoffed. "It couldn't have been _that_ much of a shock."

Violet looked up, "It was a complete and utter shock. To all of us."

"You're not pleased?"

"No — no, I most certainly am _not._"

"Whyever not?" Isobel said, shaking her head disbelievingly, "Another grandchild — a boy no less. Finally, after all these years."

"It's preposterous. Cora's too old."

"Women have babies in their forties, Violet."

"Not _easily_ they don't."

"She's in fine health —"

"It doesn't matter. The rate of genetic conditions —"

"There's no reason to think there will be anything wrong —"

"There never is." Violet said curtly. "The fact is, Cora is too old. Robert is too old. Their youngest is in college. Can you imagine, an eighteen year difference? Not to mention nearly twenty for the older girls. That's absolutely ridiculous."

"You're actually unhappy. _Truly_ unhappy." Isobel said quietly, "Violet, I — I can't say I could have predicted this reaction from you."

Violet looked down, saying nothing.

"Do you —" Isobel inhaled sharply, "Violet, do you think she should terminate?"

Violet sighed, "If she did, I wouldn't protest."

"Violet Crawley!" Isobel shouted, slapping her hand against the desk. "Cora is healthy. The baby is healthy. You can't expect her to so much as consider having an abortion just because you think this pregnancy is 'ridiculous'"

"If it's not ridiculous than what, pray tell, is it?"

Isobel stood, stomping off toward the door. She grabbed the doorknob and whirled back to Violet before throwing the door open, "A god damned _fucking _miracle."

* * *

"Um — yes, I'd like a triple americano with a bit of steamed milk if you would, please."

"Same as every morning, love?"

Edith smiled at the barista. "Yes — I suppose."

"Muffin as well? We've got those flaxseed ones you're partial to."

Edith nodded, "Nice that you remembered."

"You've been coming in here every morning for a year, darling — and like clockwork. I could set my watch by you."

From her coat pocket her phone chimed and she reached in to grab it, stepping to one side as she waited for her breakfast. It was true that she was a creature of habit. Her days were so often spent dealing with other people's chaos that she felt obligated to make her own life as predictable and orderly as possible. She drew strength from it.

**SYBIL** (_6:45 am_)

So I emailed Mary and she was like "I don't have time to respond but I did read it" like that is so typical fucking Mary. I don't think she's going to apologize to mum.

**EDITH**: (_6:46 am_)

How is mum?

**SYBIL**: (_6:50 am_)

Sad :( I'm up and making coffee and she's not even out of bed. Dad left like 20 minutes ago and you know mum. She always sees him off.

**EDITH**: (_6:51 am_)

She might just have morning sickness. Take her a cuppa. Let her sleep.

**SYBIL:** (_6:53 am_)

I will. I think she's got Mary's a Bitch sickness. Seems to be spreading through all of us.

**EDITH**: (_6:54 am_)

I've got a chronic case of it. ;)

"Here you go, love."

Edith looked up from her phone and took the warm coffee cup from the barista, thanking her. She strolled out of the cafe into the chilly, but sunny, morning and made her way down the block to the front doors of Downton Hospital.

* * *

"Isobel — would you mind sitting in on Dr. Hughes' biopsy this morning?" Dr Clarkson said, his nose already deep in a chart as he walked by the exam room Isobel was preparing.

"Absolutely, Dr. Clarkson. I was going to ask, in fact."

Dr. Clarkson smiled, stepping into the and surveying. "I suppose it's begun."

"What's that?"

"We're old now. We're all going to be dealing with the inevitabilities of that. Illness. Loss." he sighed, pinching his nose between his thumb and forefinger. "I suppose my clinical judgment is compromised by saying so but — I can't imagine what will happen if this biopsy comes back anything other than clean."

Isobel hummed sadly, "Yes. I know. It's rather frightening. I admit I went and scheduled a mammogram after she came in. I'm going to convince Violet to as well."

"Mammograms don't always catch trouble, Isobel. Self-exams are often the first line of defense, the first inkling something's wrong."

Isobel blushed, "Yes well — I'll consider that."

Realizing he'd embarrassed her, Dr. Clarkson's face flushed in kind. "Well, of course, you know all this. You're a nurse and we all know that nurses are the ones who actually perform medicine. Doctors just _practice_."

She gave him a small grin, turning back to the tray of tools she was checking. "It's frightening to think about though. How it might as well have been any of us. Me, you, Violet, Dr. Carson —"

"Isobel, at the risk of sounding like a gossip can I ask you something?"

"You can ask, I may not tell." Isobel smiled.

"Speaking of Dr. Carson — do you suppose there's something between them? He and — Dr. Hughes?"

Isobel chuckled, "I'd certainly hope so. I've never known two people who work harder and more selflessly than those two."

"I can think of one."

Flicking her gaze up, she watched a small smile creep across Dr. Clarkson's face.

"You don't mean _me_."

"I do," he said, "I'm very grateful that you've stayed on with me all these years. I know you could have gone over to the hospital proper — been in the operating theatre, on the intensive care unit — anywhere more interesting than a little family practice. But I'm very glad that you're here. Particularly so on days like today when we must care for one of our own."

"I'm happy to still be here," Isobel said quietly, "Downton's become my home. I only hope it will embrace Matthew."

"It will. In time." Dr. Clarkson said, turning to leave. He paused, then turned back. "Isobel — have you — have done something different with your hair?"

Furrowing her brow, Isobel reached up at tentatively pet her hair, which was in a very simple chignon. Same as every day.

"No — why, is there something the matter with it?"

Dr. Clarkson grinned, opening the door. "No, Isobel. You just — you look nice."

* * *

Rosamund groaned as she stumbled down the front stoop of her flat, groping the top of her head for her sunglasses. She'd gotten drunk Friday night and_ stayed_ drunk until — well, yesterday afternoon if she were honest. She felt perfectly awful, but she'd already taken a day and she didn't have nearly enough paid time to take another, so she'd made a strong cup of coffee and fried up some eggs and was hoping for the best. She tossed her briefcase into the backseat of her sedan and settled into the driver's seat, letting her head stop spinning before she clumsily put the key in the ignition. No sooner had the engine growled to life than the mix CD Sybil had made her for her last birthday blasted through the speakers.

"Oh, _fuck it all!" _she cursed, reaching to turn it down. She laid her head back against the seat and sighed, rubbing her eyes — careful not to smudge her makeup, though something made her think her efforts would be futile.

The song changed just as she pulled out of the driveway and it started off easily, so she turned it up, hoping it wouldn't cut through her with reverb.

"I _bloody_ love this song!" she squealed, "Bless you Sybil, darling."

She turned the knob up tentatively and began to sing along as she zoomed toward the hospital.

"_What I wouldn't give for only one night, a little relief in sight! Someday when times weren't so tight._ . ."

* * *

"Mum, you awake?"

Stepping into her parent's bedroom, Sybil balanced a tea tray carefully against her hip as she pushed open the door. Her mother was still in bed, curled away from her toward the window. The morning light was streaming in and illuminating trails of dust, which Sybil wrinkled her nose at as she moved closer to the bed. Settling the tray down on her father's nightstand, she settled into the mess of blankets.

"Mum?"

Cora sighed, then rolled over onto her back. Her eyes were dark and heavy-lidded, but not from sleep. More from the lack of it. She still had mascara on from Friday evening and it framed her eyes, only making her look more exhausted.

"Hello darling," she croaked, reaching up to gently place her hand against Sybil's cheek, "How'd you sleep?"

"Fine, mum. You look as though you might want to give it another go, though."

Moving to push herself up so she could rest against the headboard, Cora just rolled her eyes.

"Might as well get used to it."

Sybil turned toward the tea tray, reaching to fix her mother a cup. "Have you been sick a lot?"

Cora sighed, "Not as bad as in the past — but it's starting to feel noticeably different in other ways. Even if we'd not found out the gender I bet I'd have figured out it was a boy."

"Were you sick with me?"

"Not so much sick as just run down. Terribly run down. Your sisters were little — _quite_ little, actually — and I had a lot of running about to do. I didn't have much help either. Your father was very busy."

"I'm sorry!" Sybil pouted, handing her mother a teacup and saucer. "I hope I've made up for it by not giving you too much trouble."

Cora laughed, "Oh darling — you were a _delightful_ baby. You were beautiful right from the start and smiled all the time. You slept through the night almost straight away — very considerate, it's like you knew how exhausted I was! You were my easiest baby for sure."

"Wonder what happened to turn me," Sybil laughed, fixing herself a cup. "I don't mean to be difficult mummy, really I don't."

"Sybil, you're not difficult. Not at all. _Spirited,_ maybe. But never difficult."

"I'm sorry about what happened at dinner on Friday. I don't know where Mary gets off being such a bitch —"

"Don't call her a bitch, Sybil. She's your sister."

"Two facts about her which need not be mutually exclusive."

Cora looked into her teacup, "I don't know what's got Mary so upset but I only hope that she'll tell us — preferably before the baby graduates high school."

"Are you excited, though?"

"About the revelation of Mary's angst?"

"No, mum!" Sybil laughed, slapping her mother playfully on the arm, "The_ baby_!"

"Oh!" Cora laughed, "Of course I am. Nervous. A bit surprised by it still. I'm old."

"You're not old — 40 is the new 30. All those women's magazines say so."

"What's 50, then? I'll be the oldest mom in the preschool lineup."

"I doubt it — what about all those midlife crisis types who adopt a menagerie of kids?"

"I think it's a bit different, darling. That's quite a calculated choice."

"Well, it's not like this isn't." Sybil said matter-of-factly. "If you didn't want it, you'd just go to the clinic."

Cora paused, her tea cup halfway to her mouth. "What do you mean?"

Sybil raised an eyebrow, "Mum, are you serious? Like, if you_ really_ felt like this wasn't a good idea — if you thought you were too old or whatever — you_ could_ have an abortion."

"Darling, that's not exactly how abortions work."

"Who says?"

"Well —" Cora hesitated, "I don't know it's just — abortions are really for — you know, if a woman is raped or if she would die or the baby would die if she carried it to term. You don't just get one because you want one."

"Mum — jesus, no one _wants _an abortion. But sometimes it's just — you know, sometimes it's the right choice. I'm not saying it is for _you_ but I'm just saying like — you know, it's not like it used to be. Women have choices now. Like, it's _your_ body."

Cora nodded, "It used to be such a scary thing. Girls dying because they would have them with people who didn't know what they were doing. They would bleed out alone in their little apartments and no one would know. When your father did his emergency room rotation he lost a girl who had a botched abortion."

"Shit — really?"

"It was quite unnerving to him. I think it really gave him some insight into the very difficult choices women must face. Even today. He came home and woke me up and asked me about it. If it was really still difficult. Now, this was in the '80s. It wasn't even that long ago but — he had this idea in his mind that it wasn't like in his mother's day when women would go to the most God-awful lengths to have them illegally."

"He wants the baby too, right?" Sybil asked quietly.

"Oh yes," Cora said, waving her hand dismissively, "Very much. I think he's particularly pleased it's a boy. Not that he doesn't love you girls to pieces but — well, you know. I think he'd like to have a go at having the kind of father-son relationship he never had with his own father."

Sybil nodded, sipping her tea. "I can't begrudge him that. He's a good dad."

"He'd be very happy to hear you say that."

Setting her tea down, Sybil reached over and slung her arms around her mother.

"Don't tell him but you're my favorite." she laughed, "You always gave me the good biscuits. The chocolate ones from the Christmas tin. Those things matter, you know."

Cora laughed, kissing Sybil's cheek. "I'm very proud of you, Sybil. I want you to know that."

"Mum stop it, I'll cry."

Cora reached up and took Sybil's face between her hands, smiling at her. "Like I said, you're spirited. Your mild acts of rebellion are endearing and I love you for it. I know sometimes you're at odds with your father — and your grandmother, and even your sisters — but you a strong woman with a mind of her own — and a damn brilliant mind at that. Whatever you choose to do you'll do wonderfully, poppet. If that's not medicine, so be it. If you want to up sticks and go to Cambodia, than do it. You've always danced to the beat of your own drum and it's never lead you astray," she kissed the girl's forehead. "Because you're following the beat of your own heart."

* * *

"Dr. Hughes will be late this morning," Beryl announced as she tossed her bag into a chair at the nurses' station. Daisy, Phyllis, Anna — and Molesly — all looked up with interest. Dr. Hughes was _never_ late.

"Is she okay?" Anna asked.

"Oh yes, just has an annual is all." Beryl said, shrugging off her coat.

Unconvinced, but not wanting to try her luck with Beryl first thing on a Monday morning, Anna exchanged nervous glances with Phyllis and went back to her work.

"Can I do rounds with you?" Daisy asked, hovering at Beryl's side.

"I'm _expecting_ you too." Beryl said, wrapping her stethoscope around her neck. "Not only that, you're scribing for me."

Daisy brightened, turning to Anna excitedly and giving her an excited grin. Anna wrinkled her nose playfully at the girl and Phyllis gave her an assured wink.

"How is she so bubbly this early? Molesley yawned.

"Not feeling quite alive yet this morning?" Phyllis said, nudging his coffee toward him. "You'd better perk up, we've got three new admits from the overnight."

"Three?" Anna said, pushing her rolling chair over to Phyllis' workstation. "I thought there were just the two — whose the third?"

"Well, there's the girl who came in from psych — she was transferred Friday but was observation until last night. They've admitted her — looks like she's got a brain tumor or something of the like?"

"Yeah, I knew about her —?"

"Uhh, then there's a girl recovering from an emergency appy, which was complicated — looks like she had perforation?"

"Yes — Charlie, we met yesterday."

"Okay — well, then this must be the one you've not met. Came in last night, admitted here from the ED." Phyllis handed the chart to Anna and reached for her bagel, "Dr. Hughes hasn't seen to her yet — whoever was on call stabilized and admitted her but —" she sighed, "Not looking good."

Anna studied the chart a moment, then flicked her eyes up at Phyllis just as she popped a bite of bagel into her mouth.

"This sounds like MS — but she's only —?"

"I know, 22. She's just a baby."

"Not definitive?"

Phyllis swallowed, shaking her head. "Neuro's coming in for a consult but I'd take Dr. Hughes' word over theirs, honestly."

Anna nodded, "What room is she in?"

"242."

"Has she had morning vitals?"

"Last ones were at 5 — you could go get a blood draw. She's sweet. Her name's Samantha."

* * *

"_What then, Dr. Hughes? Where do we go from here?" he says through halting breaths._

_She's nearly there, her feet against the ground, her hands gripping the desk as she feels her muscles begin to hold themselves in that pleasant tension, feels the dampness spread and the heat starting low and, like a flash of flame, rising up her chest and alighting her face with a pretty blush. She whispers, but swallows her words._

"_Tell me," he says, pulling her tighter against his body._

"_We come," she breathes._

"_What happens?" _

"_The — the tissue swells, blood rushing — and, unh, muscular spasms and — unhh, ahh, vocalizations." _

_She feels it then, the sweet fall, the tingling and the pleasant thumping pulse of her sex. She makes a sound, somewhere between a cry and a laugh, and he reaches a hand up, fingers against her mouth, and she bites down, letting her tongue flick across her lip and—_

"**Everybody here is out of sight****, ****they don't bark and they don't bite****, t****hey keep things loose, they keep it tight****, ****everybody's dancing in the moonlight****!" **

She startles awake, drenched in sweat and — something else. The radio on her nightstand blasts _far _too loudly next to her head and she struggles to throw the covers back and reach for the knob that will turn it off.

"**E****verybody's dancing in the moonlight****!"**

"Damn it all!" she curses, pushing herself upright, head spinning, and letting her hand come down hard against the radio. Silenced, she blinks awake, struggling to catch her breath. She throws the covers back and notices that her sheets are damp. She shakes her head, thinking —

"Oh, _fuck_." she whispers, bringing a hand to her chest. Something residual twitches somewhere low and forgotten (or undiscovered, even) and she brings her fingers up to her face, gently touches her flushed cheeks.

And despite herself, despite the sun rising up and shining in her window like a policeman's streamlight, despite the vague shame she feels at what is alive and beating wildly inside her — she allows herself a tiny, secret, _satisfied, _grin.


	18. Mortality

**A/N: IT'S A LIL' NSFW, MY LOVE AND THANKS TO DEEDEE WHO IS MY BETA-GODDESS FOR SEXY BITS. **This is a long, Chelsie-centric chapter. There are surgeries. Angst. Fandom patients. Y'know, goodies. Thank you for staying on this journey with me, even when I'm slow on updating because researching this fic is sometimes really, really exhausting but I'd be lying if I didn't admit that I fucking love every minute of it! ;)

* * *

Dr. Clarkson had said it would only take a few days for the results of her biopsy to come back from pathology. Weeks tended to pass her by in a flourish; Wednesday arriving so quickly it may well have been Monday afternoon, but she knew this week would be different. She straightened her white coat as she headed down the long hall towards pedes. Her stethoscope, bouncing against her chest, made her cognisant of how tender her breast was. _You may bruise. It will be tender for several days. _Unraveling the stethoscope from her neck, she turned it around so that it was on the other side; it felt entirely foreign. But she could hardly be wincing all day.

She rounded the corner toward her office and saw that Dr. Carson was standing before her door, his hands busy with two cups of coffee and he was trying to figure out how he would go about knocking. Her heart leapt in her chest. _Residual nerves _she rationalized, _nothing to do with him. _

"That was _excellent_ timing," she smiled, coming to his side. He turned, sighing with relief.

"Oh — indeed!" Dr. Carson said, handing her a cup of coffee, "Did you have a nice weekend?"

Elsie swallowed, letting her gaze fall on her hands. "Yes — I did, Dr. Carson. And thank you again for your hospitality Friday evening. I had a lovely time."

"It was my pleasure. Really." he said as she unlocked her office door. He let her take a few steps in then followed, pulling the door shut behind him.

"I won't keep you, I'm sure you've got as busy of a Monday ahead as I — if not more so — but I just wanted to bring you some liquid courage." he smiled, hovering by the door.

"Actually, Dr. Carson, if you wouldn't mind — having a seat for a moment?"

"Oh," he said, his face growing worried, "Of course. Something wrong?"

He settled in, setting his coffee on her desk and leaning toward her.

"I've just come from my biopsy." she said quietly, "and — well, I won't know anything for a few days but — well, it got me thinking that perhaps I should — well, I thought I should —" she shook her head frustratedly, letting out a deep sigh. "In case anything happens I need to have my affairs in order, you understand."

He nodded, holding her gaze. She wondered if she was too anxious, if her words were bubbling up out of fear and uncertainty. She should have waited, thought on it – slept on it, even. She could stop. She could back-peddle — apologize, pass it off as nothing._ Silly, anxious thoughts._

He was looking at her so calmly, so kindly. And there was something else there for her in his dark eyes. It wasn't something she could ascribe a name to, but it made the tension of her muscles relax. It made her want to smile.

"I was thinking — I don't have any family except for Becky and — well, she can't have any assets left in her name, but I can leave anything — money, property — to her in trust. Well, I suppose since there's no one else, and she wouldn't be able to take care of my affairs. I —" her voice trailed off and she laughed nervously. "I didn't know this was going to be so difficult."

"It's a rather delicate topic," he said quietly, "I would — if you're looking for someone to help you draw up a will — well, I could certainly put you in touch with my attorney. I spruce up mine each year on my birthday so I don't forget —"

"Dr. Carson I was hoping perhaps you would consider — maybe you—" she took a deep breath, then exhaled slowly, "Perhaps you'd like to come for dinner on your next night off? I would like to return the favor from Friday and — and perhaps it would be easier to discuss this matter in a less clinical setting."

"I would like that very much, Dr. Hughes. I'm afraid if this is heavily pressing on your mind, though, tonight is my last night off call for. . .well, about three weeks."

"Oh," she said quietly. "Well — I'm not on call until Wednesday." she lowered her gaze, picking at a stubborn hangnail she'd started tugging at in Dr Clarkson's waiting room, "I hope you won't think me presumptuous and it's terribly short notice but — perhaps you'd like to come for dinner _tonight_?"

"Yes," he said, rather too quickly. They both laughed nervously. "Ah, yes. Yes I would. I could — ah — bring a copy of my papers if — if you need a bit of guidance."

"That would be helpful, thank you." Elsie said, suddenly flustered.

"I don't mean to imply I think you need them of course — I'm sure everything will be fine."

"You can't be sure of that." she said simply, "No one can be." Elsie laughed sadly, "But I appreciate your optimism, Dr. Carson."

There was a moment of quiet between them and he reached for his coffee, "Well, I'll let you get on with your day. Ah, what time should I — ?"

"I'm hoping to leave by 5 o'clock today. If you'd like to come around 6? We won't let it get late."

He smiled, "Good thinking. It is a Monday after all."

"Yes. Well."

"Should I bring anything?"

"Just that paperwork, Dr. Carson." she said, "And your optimism."

* * *

"Don't judge me, it's probably the drugs and the shock of it all, but I can't stop laughing at the idea that of all the brain tumors I could have, I just _had _to get the one with _ass_ in the name."

Anna laughed, winding the tourniquet from Stephanie's arm.

"You've got to find the humor in life," Anna said, "Not that it's ever easy but sometimes it's the best medicine, really."

Stephanie blanched, swallowing hard as Anna reached for the syringe.

"I'm sorry, I'm — I get kind of weird about needles. Well, about blood actually. Like —" she closed her eyes, letting out a shuddered breath. "Like just hurry — maybe?"

Anna smiled, "You'd be surprised how common it is to be afraid of them. Though you're faring considerably better than many of the _men _I've taken blood from."

"Yeah?"

"Mhm," Anna said, dropping a tube into her scrub pocket, "Men are the worst to do blood draws on."

"Probably because they don't like, _see it_ every month."

"_Precisely_!" Anna said, pressing gauze against Stephanie's arm. "There we are, all done."

"Wow, you're _good._ I didn't even feel the needle."

"It's my super power," Anna grinned, giving her a wink.

Stephanie slunk back into the bed, reaching for the book she'd been reading. A textbook, Anna hadn't caught the title, but it was enormous and reminded her of nursing school.

She shuddered.

"Happy to see you're still eager to pursue your studies," she said, reaching for the mobile computer unit.

"I kind of need the distraction," Stephanie said without looking up, "If this doctor tells me it's fatal or something I'm gonna have to ditch the books and have some kind of midlife crisis. Buy a fast car. Skydive. Have tons of ill-advised sexual adventures."

"You could have a smashing career in comedy," Anna said, "Perhaps you should start there."

Stephanie smiled, "I think you have to have a sense of humor to go into teaching. That's what I'm studying."

"What years?"

"Primary, little kids. I like kids. They're way more honest about life than adults and I find that terribly refreshing."

Anna opened Stephanie's chart and squinted at the screen, typing in the lab requisition.

"Dr. Hughes should be along shortly—" Anna began, but no sooner had she opened her mouth to speak than the doctor made her way into the room, a rather large textbook pressed against her chest.

Stephanie looked up from her own and laughed. "Somehow I gather _that_ textbook isn't on early childhood development?"

Elsie came over to the side of her bed, pulling a rolling stool with her so she could sit.

"Not quite — pediatric oncology." she stuck her hand out to shake Stephanie's and saw that the girl's face had fallen. She let her hand fall and rested the textbook in her lap, folding her hands atop it. "Stephanie, I'm sorry — that was rather misleading."

"So this thing is cancerous? Like _A Walk to Remember _cancerous?"

Elsie raised an eyebrow, the reference lost to her. "No, in fact – it's _not_ cancer. It's just that —" she put on her glasses and opened the text to a chapter she'd previously marked, she nudged it on to Stephanie's lap, "It's more about positioning. See, this is the pathology of an astrocytoma — that's the type of tumor I believe you have. Dr. Anstruthers, the radiologist, agrees with that assessment." she looked up and noticed for the first time that no one else was in the room. "I'm sorry — Stephanie, where are your parents?"

The girl winced a bit, almost imperceptibly. "They've — ah — they've _gone out_."

"Perhaps I ought to wait and go over this with you when they've returned."

"I'd rather you not. I'm twenty-two so, I'm adult and I'll be the one making the decisions. I'll be the one dealing with it."

Elsie regarded her curiously, "You don't think perhaps your mother would be displeased to not have spoken to me herself? I happen to have a lot of experience with the mother's of my patients and they —"

"With all due respect, Dr. Hughes, I'd really rather you not." Stephanie said levelly, "I'm sure you are _very_ busy, you've got lots of other patients to see — it's a damnable Monday — and I don't want to take up any more of your time. So, if you would — just _get on with it_."

Elsie blinked, then looked back at the text. "Well — alright, then. Let's start here. As I was saying before, it's about positioning. The placement of the tumor is what makes it troublesome. The first thing to know about this tumor is that it's not what you normally picture: it's not some ugly, horrid, fleshy thing. Not that I suspect anyway. It's most likely cystic. If there is a solid mass, it's probably encapsulated by the cyst."

"So —like a _Pokeball_?"

Elsie looked up from the text, "Well — I'm not sure what that is but — maybe?"

Stephanie laughed, "Sorry, my sass goes into overdrive when I'm nervous."

"Well, you can relax a bit — it can be removed surgically. You may not even require any radiation."

Stephanie nodded, "Okay well — when do we do it?"

"Our new pediatric neurosurgeon is arriving this week — _Dr. Swire_ — I would like to have her perform the surgery. You can recover here, we'll work with neurology to monitor you post-operatively, and should you need any chemo or radiation after, that's something we'll tackle when the time comes."

"So I just sort of hang around here with some weird ass-thing in my head until she gets here?"

Elsie chuckled, "Pretty much." she nodded toward Stephanie's textbook, "Teaching is a noble, but thankless, profession, my dear. I applaud you."

"_Gee thanks_," Stephanie said dryly, but she smiled. "I always get really defensive when people say teaching is easy. I will literally _dick punch_ anyone who says that to me."

"That's a colorful expression," Elsie laughed, "I may have to tuck that one away for _particularly_ difficult residents."

"Yes, please do." Stephanie said. Elsie pat her leg reassuringly and stood to go. As she reached the door, Stephanie called to her. "And Dr. Hughes?"

"Yes, dear?"

"Just — um. Thanks."

"For?"

"For — well, for just talking to me like I'm an adult and not acting weird because — because my parents aren't here."

Elsie hovered in the doorway, then took a few steps back toward the bed. "They've not just 'stepped out', have they?"

"No, they're — well, they're just _busy_. With other things. I mean if I have surgery they'll come by but — you know, I think it would be better for me to just handle this on my own. I think if they were here it would be a million times harder."

"I have to admit that's rather the opposite of what most people in your situation would be saying right now."

Stephanie sighed, turning back to her textbook, "I'm twenty two and I have some bubble in my brain that's making me literally go crazy. I'm not most people, Dr. Hughes."

Elsie smiled sadly, "No. I suppose you're not."

* * *

"You'll never guess what I heard on line at the coffee cart!" Daisy said breathlessly, sidling up next to Anna in the nurses' station.

"Good lord, catch your breath." Anna laughed, looking up from her computer, "What?"

"Cora Crawley is _pregnant._"

Anna blinked, "Wait — Cora? Mary and Edith's mum? Are you sure?"

Daisy nodded, "And it's _a boy_ this time."

"_Oh my God,_" Anna gasped.

"What are you tittering about, Daisy? Don't bother Anna she's behind on her charting." Beryl said, coming around the corner.

"I'm_ not_ behind!" Anna said.

Beryl sighed, "Well she didn't know that." she watched a look pass between the girls and narrowed her eyes. "What secret are you keeping?"

"Nothing." Daisy said.

"Daisy, I know you've only been here a week but surely you've figured out by now that I _know_ when you're painting a turd gold and trying to tell me it's a Cadbury egg."

Anna snorted, turning back to her computer screen.

"I swear, it's nothing. It's just — gossip." Daisy said, moving past her.

"Well I want to know!" Beryl said, grabbing Daisy's arm and pulling her back. "Spill it."

"You _don't_ want to know, Beryl. You'll drop dead of a heart attack right there."

"Well, now you've_ got_ to tell me."

"Tell her what?"

The three women looked up to see Dr. Hughes hovering at the counter of the nurses' station.

"_Oh shit_." Daisy breathed.

"Relax," Dr Hughes said, pushing her glasses up onto her forehead, "It's Monday, I'm undercaffeinated, my first patient this morning has a brain tumor and the cafeteria didn't have any of those little donuts I like—please give me something to be enthused about."

"You heard the doctor, Daisy. Tell us." Beryl sad, leaning toward her.

"I heard it but I don't know if it's true _ but — Cora Crawley is pregnant and it's _a boy._"

Beryl guffawed, slapping her hand against the desk. "_That's_ a crock of shit!"

Anna and Daisy laughed, but stopped when they saw that Dr. Hughes hadn't so much as broken a smile and was, in fact, looking down at her hands.

"Elsie, what's up your ass?" Beryl said, but when she looked at her face, she quieted.

"You know, when she came to my office the other day I thought she looked rather _aglow_." Dr. Hughes said quietly, "If _it is _a boy I imagine Robert is probably over the moon."

"Don't you think it's kind of — I don't know —_incredible_ that she could get pregnant?" Daisy shrugged, "Mary's gonna be — like — 25 years older than the baby!"

Dr. Hughes looked up, "A woman's life doesn't have to be over just because she reaches a certain age, you know." she snapped.

"I'm — _I'm sorry_, Dr. Hughes, I didn't mean—"

"Anna, who do I need to see next?"

Clamoring for a chart, Anna handed it to her. "Samantha — 242."

Taking the chart without looking at Anna, Daisy or Beryl, Dr. Hughes studied it. "Is this_ another_ neuro case?"

Anna nodded, "Well, potentially. When is Dr. Swire arriving?"

Dr. Hughes huffed, heading off down the hall. "Not bloody soon _enough_, apparently!"

* * *

Carson scrubbed his hands a bit harder than necessary, but he needed to focus. He couldn't be worrying about what Dr. Hughes did-or-did-not think about him, _about them, _when he was about to perform surgery. Given, it wasn't as though he'd not done several thousand cholecystectomies in his career. Still, any surgeon was a risk for the patient, no matter how straightforward it appeared to be according to a textbook. Perfectly sterile, he backed into the OR and waited for the scrub nurses to finish suiting him up.

"Wouldn't expect to see you on this one, Dr. Carson. Uncomplicated lap cholecystectomy?"

"Yes, well, I'm doing it as a favor. Dr. Flintshire needed to attend to another patient."

This was a lie, but the nurses didn't question it. Charles had, in fact, nearly begged Dr. Flintshire for the surgery. He needed a distraction, needed something to think about other than his own fluttering heart, how his stomach dropped whenever he heard Dr. Hughes' name.

"Shall we begin?" Charles said, his voice muffled from behind his surgical mask. The scrub nurses looked expectantly at him; he was conducting this symphony. It was his move, not theirs. He cleared his throat nervously, "Chlorhexidine, please — and prepare the sterile drapes?"

"Of course, Dr. Carson."

As he prepped the surgical site, he eyed the scrub nurse. He didn't recognize her.

"Are you new to Downton?" he asked, handing the sponge across the patient's body to her.

"In a sense." she sighed, "My ex-husband is employed here and I try to give him a wide berth."

"Oh?" Charles said, "Do you mind if I inquire as to who —"

"John Bates," she said. "And yes, he knows I'm here. He's pointedly avoiding me. I was working at St. Mary's but — well, it's not important why or how I'm here. I suspect it's only transitory. Until I decide my next move."

Charles grunted in acknowledgement, "Well, Downton is a very small hospital I'll admit that. If you've chapters of your life you'd prefer to keep unpublished you may wish to seek employment elsewhere. But, in any case, you're here now — so, if you would please, pass me a Kocher clamp. I'll begin with a longitudinal incision is made at the inferior aspect of the umbilicus, then deepened through the subcutaneous fat to the anterior rectus sheath."

The nurses chuckled knowingly; Charles Carson always narrated surgeries as though he had an audience of students; even when the operating theatre observatory was empty.

"15-blade, please." he sighed, rather uncharacteristically. "She seems a bit young for a cholecystectomy."

"She's _full _of stones." the nurses tutted, "Seems a fluke, almost. No prior history, nothing. Poor thing."

"Well, she'll be on the mend soon enough. Now, let's see. . . 11 mm blunt trocar." Charles said, threading the scope into the incision he'd made, "Visualizing the gallbladder and —"

Behind him, monitors began to skip and bleep. The anesthesiologist furrowed her brow.

"She's a bit hypotensive. Saline bolus?"

Charles paused, his hands hovering above the incision.

"Ah — yes. Yes, thank you."

He grasped the clamp in one hand, his scope in the other. Suddenly his palms had become damp with sweat, his gloves uncomfortably sticky against his skin. He exhaled, letting his eyes flutter closed for a moment.

"Dr. Carson —?" the nurse said, "Everything alright?"

"Yes just — just waiting for that saline. Want to make sure her pressure doesn't drop again."

"She's stabilized, Dr. Carson." the anesthesiologist said gently, "Proceed."

"Right. 5-mm grasper — place it here, if you would." he said, nodded to the scrub tech. He stretched his neck side to side, easing the tension that had settled in his upper back, "We'll retract; oh. . ." he said quietly, "That's quite densely adhered. Cautery?"

Handing him the cautery tool, the nurse sighed. "No wonder she was so ill when they brought her in —"

"Her pressure's dropping again," the anesthesiologist said, monitors beginning to bleep rapidly behind her.

"Epinephrine, IV push." Charles said, glancing up at the monitor. "Was she hypotensive in pre-op?"

"Not according to her chart," a nurse said from the computer at the edge of the operating room.

"Lysis of adhesions is complete, but we'll need to work fast to remove the gallbladder. It's in here somewhere. . ." he grumbled, staring intently at the video screen that showed his progress.

A quiet chime rang out from across the room, which he recognized as his cell phone.

"Would you like me to get that for you, Dr. Carson?" the scrub nurse said, the one from earlier who identified her as the former Mrs. Bates.

He hesitated; the only person who ever texted him was Dr. Hughes. Perhaps it was urgent.

"If you would, please."

Stepping away from the operating table, the nurse moved to the edge of the room. She glanced at his phone, then read it aloud to him.

"It's a text from Dr. Hughes and all it says is —" she paused, her eyebrows flaring, "_Can we make it closer to six-thirty, I have a new patient and won't be finished documenting until at least 5 o'clock." _

The operating room grew silent; Charles felt his face flush, the heat rising to his ears.

"Tell her yes." he said curtly, "Now, let's close before this poor woman's blood pressure drops _again._" he turned back to the anesthesiologist, "And for the love of God, page me as soon as she wakes up in recovery."

* * *

"Now, I'm _not_ a neurologist," Elsie said quietly, laying a gentle hand on the girl's quivering knee, "And when Dr. Swire arrives she'll do a more thorough exam. But for now, I would like to proceed with what the doctors who admitted you suggested."

The girl, Samantha, looked up at her with fearful, tired eyes. "Which is what?"

Elsie sighed, removing her glasses. "You were brought in from your university dorm after you fainted. There was a professor who accompanied you, said that you hadn't been yourself for quite some time. You'd had trouble climbing stairs, couldn't seem to focus on the conversations in your courses. She mentioned that even your handwriting had changed."

Samantha nodded, her gaze lowering. "I was in a lot of pain. My body felt. . .my arms, my legs, almost like they were on fire."

"But you were still going to class."

"Of course," Samantha said, "I couldn't get behind."

"But you were very clearly _ill_," Elsie said.

"I thought I could push through it."

"Until you collapsed."

"Yeah."

Elsie sighed, patting Samantha's knee. "I've scheduled an MRI for this afternoon. And I'm afraid that Dr. Swire will always want a spinal tap."

Samantha cringed, "A needle — right?"

"Yes, but you'll be fine."

"Will you be there — when they do it?"

Elsie smiled, "I can be."

"What — what happens if it is? If it is what they thought?"

"Multiple sclerosis is manageable," Elsie began, "There are medications you can take. We may need to wait and see what course it will run. Sometimes people have relapsing-remitting MS, which means they have periods where their symptoms are very severe, and periods of time where they go away completely. Sometimes years, even. And you're young —"

"I don't feel young," Samantha said, "I'm so tired and —" tears glistened in her eyes and she quickly wiped them away, her face flushing with embarrassment. "I'm sorry, this is all —"

"Frightening, I imagine." Elsie said, "When will your parents be arriving?"

Samantha looked up at her, snorting. "They won't be — why would they —?"

Elsie furrowed her brow; _why so many wayward girls today_? She reached over and tucked a loose strand of hair behind the girl's ear.

"Samantha dear, there's someone I think you should meet while you're here. . ."

* * *

Charles laid out all the paperwork he would need: wills and testaments, his attorney's contact information, all the how-to guides he'd printed off the internet, as well as information about the body donation programs of all the major universities and teaching hospitals. It felt terribly odd, uncomfortable, like scratchy wool — but _inside_ of him.

But, she'd asked. _She'd asked for his help. _And he wasn't about to let her down. Wasn't about to give her any reason — any further reason, he supposed — to think he didn't care about her.

For her?

He remembered then, for reasons that his mind may not have fully appreciated but were driven by heart strings that needed tuning, the first surgery they ever scrubbed in on together. A trauma, of course. Summer of 1988. He remembered because she was new, it was an uncharacteristically warm summer and the operating room buzzed with machinery and table top fans that attempted to keep them cool. Her hair was longer, and more auburn than dark, and neither of them had need for eyeglasses. The patient was a little girl, no more than five, named Chrissy. She had been in a car accident and was unstable, massive internal bleeding. A head injury.

_Charles had stared at the child a moment, the ventilator pumping angrily next to him, all of the circulating nurses in a choked hush around him as he collected himself. Then, the operating room door burst open and in came Dr. Elsie Hughes. The nurses murmured; some had met her, others had only heard about her. She entered the sterile field, standing across the operating table from him, and stared at him expectantly. _

"_Tell me how best to help you," she said evenly, "I intubated her when she arrived and it's clearly a Class IV hemorrhage. You've a dreadful amount of work ahead of you, Dr. Carson." _

"_While I make the preliminary incisions, please continue to monitor her vitals; when I've found the source of the bleeding, I'll require your help to staunch it. You can get sterile gauze and dressing from the scrub nurse to pack it." he said. "Has she been started on vasopressin?" _

_The anesthesiologist nodded, "And H2 blockers but she's barely stable." _

"_Good God," Charles gasped, having opened the child's abdomen, "Dr. Hughes — apply direct pressure here, her spleen's ruptured and —" the blood came fast, covering his gloved hands, soaking the draping — reaching over and dipping her hands in, Elsie met his eyes across the table, waited for his next instruction. "Give her a unit of Type O and packed RBCs" he said, then looked up at Elsie, "If I don't find the source of this bleed she's going to exsanguinate." _

_Her hand staunching the splenic rupture, Elsie felt her knees begin to shake. "Her blood — it's not clotting — it's not clotting at all." _

_Carson paused in where he was inspecting the intestines, "Is she hemophilic?" _

"_I don't know," Elsie said, "Girls are usually only carriers, they don't have frank symptoms —" _

"_They can," Dr. Carson said, "Was there any mention in her chart?" _

"_No," Elsie said, flexing her fingers against the child's spleen, which pulsed weakly under her hand, "And the father —" _

"_What?" _

"_He's drunk," Elsie said, "I think he's passed out on a stretcher somewhere. . ." _

"_Jesus," Charles said, "Another unit of O, stat!" _

"_It could be in her joints," Elsie offered. _

"_Dr. Hughes, it's everywhere." Charles said, furiously packing the abdominal cavity, "She's bleeding profusely — I can't —I can't control it." _

"_You have it," Elsie said firmly, "Dr. Carson, you have to." _

"_I can't," he snapped, "You didn't know she was hemophilic, she did not have proper prophylaxis, she wasn't given enough crystalloid, and now she is going to bleed out on this table and there's nothing I can —" _

_The monitor beeped loudly next to his ear —_

"_She's coding," the anesthesiologist said._

"_Epinephrine IV push —" Elsie said._

"_No point, we just pushed vasopressin." The anesthesiologist said, giving Elsie a glare. _

"_Well — give me the paddles," Elsie said, lifting her hands from the child's spleen, which immediately began to bleed. _

"_Dr. Hughes!" Charles shouted, and she dipped her hands back into the body cavity, her face gone scarlet behind her surgical mask. She felt her eyes stinging with tears. _

"_She's been down —" _

"_I know," Charles said, "If I can just —" _

"_Dr. Carson—"_

"_Just wait—"_

"_Dr. Carson!" _

_The operating room was quiet except for the echoing heart monitor flatlining and the angry whir of old fans, which spread the metallic scent of blood around the room. _

"_Time of death, 9:17 am." Charles said, stepping back from the operating table._

"_What — that's it?" Elsie said, "But we —" _

_Dr. Carson turned and left the room, his body pushing through the door with a loud thud. Elsie gently lifted her shaking hands from the girl's body and stepped back from the table, tears damp against her cheeks. She wordlessly left the operating room, walking in a daze to the locker room. Stripping off her bloodied scrubs, she stood in her bra and panties in front of the shower stall, shaking violently. _

"_Dr. Hughes, I–" _

_She whirled around, wrapping her arms around her middle to cover herself. He stood at the edge of the room, already in fresh scrubs with damp hair — and he kept his eyes on hers. _

"_I wanted to apologize. You did the very best that you could. But that child could not have been saved and no amount of —" _

_She cried, then, ugly violent tears. Forgoing all sense of propriety, she lifted her hands to cover her face, her shoulders shaking. _

"_I'm —I'm sorry." he said quietly, as if he'd only then realized that he'd walked in on her in such a state of vulnerability; spiritual and near-physical nakedness that he wasn't privy to. He backed around the corner, pressing himself against the cool tile of the locker room wall. He listened as she turned on the shower, and cried as the water pulsed hard against her skin._

_He stood there, paralyzed, listening far longer than was appropriate. _

* * *

"_Shit,_" Elsie murmured, staring into her small, but typically diversely stocked, liquor cabinet. She was out of red wine. _Completely_. All she had was mixers, gin and enough vermouth for a few martinis. _You can't offer him a martini, Els. _She thought, shaking her head lightly as she headed back into the kitchen. Spaghetti bolognese, the one dinner she could cook without fail, warmed on the stove and she knew he'd arrive exactly on time. She smiled; he was if anything, predictable. _Reliable. _

Stable.

_Her legs begin to shake and he feels her weakening, lowers himself into her chair, lets her rest on his lap. He rubs his hands down her thighs, presses his nose into her hair, nuzzling it from its tight bun, unruly curls falling onto her shoulders. _

"_Is this step one?" he says, walking his fingers up her sides, smoothing his hand around her ribcage, _

"_Excitement?"_

"_Yes," she breathes._

"_What happens?" _

"_What?"_

"_What happens to a woman in this phase? What happens to you, Dr. Hughes?" _

_Her breath is tight in her chest, she starts to speak but only gets so far as a low moan. She shakes it off, pulls her bottom lip into her mouth. "Oh — unh, heart rate elevates. Systolic blood pressure unh, rises." _

"_What else?" he hums, bringing his hands up to cup her breasts over her blouse, kneading them, pushing them against one another, inhaling sharply, his breath hissing pleasantly over his teeth. _

"Oh, stop." she breathed, chiding herself — a knock on the door. She glanced at the clock. He was right on time. She'd been home just long enough to start dinner and change out of her work clothes. Heading toward the door she suddenly felt insecure to be seen by him in jeans and a sweater. _It's a nice, sweater, _she thought, pausing in front of the hall mirror to check that her face was still made up, hair still tidy. Her eyeliner was a bit smudged, but maybe he'd not notice. He wouldn't be that close to her —

"_Unh, um — the nipples — they're — they become —" she exhales smoothly, her voice curling over the word, her accent lilting strong as she loses her resolve, "erect." _

"_And?" _

"_And — oh," she breaths, opening her eyes and looking down, the sight of his hands on her, enjoying her, making something stirr. "Well — the – the vagina lubricates?" _

"_What they would call getting wet?" he asks, knowing damn well the answer. _

"_Yes," she says, rising up from his lap as her back arches, his grip on her breasts tightening. He pulls her back down, smooths his hands around and takes her by the waist, pressing kisses the length of her neck, sucking gently. _

"_Dr. Carson —" she says, turning her head away, but he reaches up and slides a hand from her chin up the side of her face, pushes the hair from her face. He slows his movements. She sighs deeply, uncertainly, watches as he moves his hands down the front of her blouse, dips them under the waistband of her skirt._

"Elsie Margaret Hughes, that is _enough!" _she whispered, bustling toward the door. He stood in the hall, smiling almost sheepishly.

"Hello," she said, stepping back into the entryway of her flat, "Come in. I'm so glad that this — worked out."

"Ah, yes — as am I." he said, setting his briefcase down so that he could slide off his coat. She noticed he was still dressed from work. He must not have even had time to go home before he came by. "I know you've been a bit distracted; with good reason."

She reached for his coat just as he turned to hang it on her coat hook. Letting her hand drop awkwardly to her side, she gestured down the hall toward the kitchen. "I hope you don't oppose spaghetti bolognese," she said, "I admit it's the only thing that I cook that I'd dare let anyone else eat."

Charles laughed, taking in her kitchen. Compared to his, it was quite modern. Lots of chrome, marble countertops. A dishwasher. A garbage disposal.

"Have a seat, please." she said, lifting the top of the pot on the stove. "Would you prefer we eat first and then we can — _ahm — _go over the paperwork? I just mean — it could get messy."

He sat down slowly, raising an eyebrow at her curiously.

"With the — with the bolognese." she said, gesturing to the stove.

"Oh," Charles said, "Yes — I suppose that would be wise. I appreciate that you took the time to cook a meal. I — well, you can't have had much time. Between work and — and home. I hope you won't mind my saying but you've more domesticity about you than I would have suspected."

She sighed, lifting two heaping plates and moving to join him at the table. "That's kind of you, Dr. Carson. I would be a liar if I led you to believe it were true, however."

He nodded in thanks as she set the dish in front of him. Unfolding his napkin and resting it in his lap, he looked about the room. "Well, your flat is marvelous. Much more modern than mine, what with your appliances and all that. And it's so nicely decorated."

She blushed, "Well, I can take credit for that. But the rest is all thanks to a maid who comes in once a week to hoover and whatnot."

"Very sensible," he said. "Perhaps you would bequeath me her phone number. I could use some tidying up."

"Your place was spotless," Elsie chuckled. "What could possibly need tidying?"

"My bookcases mostly."

Her bottom lip trembles as she watches him wind pasta against his spoon; unaware.

She coughs suddenly and he flicks his gaze up at her with concern.

"I'm alright," she says, reaching for her water glass. "Down the wrong pipe, as they say."

Charles laughs, his fork partway to his mouth. "Good thing I'm a doctor."

"_Dr. Carson," she breathes, but she can't take her eyes from his hands even after they disappear under the wool of her skirt, under the dark curls hidden there, taps lightly, tentatively, until she tenses under his touch and he knows he's found it; his clue. _

"_Next phase?" _

_She bites her lip against, starting to like his little game, "The body prepares for — for pleasure—" she feels her lips parting in a smile, "the clitoris—" _

_He pressed the pads of his fingers against her, asking with his hands instead of his words. _

"_Yes," she says, her feet hitting the ground hard as she slides from his lap slightly. He eases her back up, slides her across his fingers in the process and a small fuss escapes her. _

"_The clitoris?" he asks, "What of it?" _

"_It becomes — primed — it — it responds to — stimulation." _

She lays her palm flat against the table, atop her napkin which her palm immediately dampens. Her fingers curl against it, bunching it up. Something is stirring in her and it must be stopped.

"Dr. Carson," she says, a bit too loudly. "I'm a terrible hostess, not even offering you a drink."

"I thought we were having drinks after— with the paperwork?" he said, eyeing her.

"Right," she breathed, turning back to her plate, which she could hardly think of managing now that her hands were shaking so.

"Are you alright?" he asks, setting his fork down. "You look a bit —"

"I'm just nerved up, Dr. Carson." she said, her eyes fluttering closed. "I know I'm no longer young by any stretch of the imagination, and I'm not stranger to our collective human mortality, but I find myself heavily preoccupied and I apologize."

"Of course you are," he said gently, "You needn't apologize. There's nothing so human as fretting over your own well-being."

She smiled, "I suppose not. You'd think, being a physician, I'd have been more prepared."

He shook his head, "Common misconception, Dr. Hughes. Practicing medicine affords us no such immunity to the primal fear associated with facing our own inevitable death."

"That's cheered me up." she said. He hesitated, his eyes worried, but she grinned. "I'm only teasing."

He laughed, relieved, and returned to his food. "I refuse to believe this is nothing but an old stand by." he said, "Though, as a perpetual bachelor I admit my culinary knowledge is a bit limited."

"I'll send you home with the recipe." she says, "We can't have you starving to death."

The word is strange on her tongue, and an understanding of its newfound awkwardness passes between them. The kitchen grows quiet but for the sounds of forks clinking against porcelain and her shuddering breaths.

* * *

He offers to help wash up but she just laughs, "That's what I've a dishwasher for, Dr. Carson.", so he excused himself and went into her living room to begin laying out the paperwork he'd brought. His own estate papers, living will — even his official paperwork decreeing his body would be donated to Downton's teaching hospital after his death. He sat back against the couch cushions and waited.

When she came around the corner and saw him there, her heartbeat quickened and though she knew why, she couldn't believe the reaction was so real when the impetus was merely — what, a dream? Not a fantasy. Just jumbled, sleeping brainwaves. Neurons sorting themselves out while she slept.

Still, her nerves tingled and almost hurt; she thought of her patient, of Samantha, a girl on fire. _Maybe it's just neuralgia. _She thought. _I'm an old cow, it's about time I have niggling symptoms of old age, and maybe that's where the dream came from — incipient dementia —_

"Dr. Hughes?" he said, "I hope you don't mind, I moved a few of your books on to the chair, to free up space on your coffee table."

She blinked, eyeing the chair which was now piled with a few largely unopened books. Looking back at him she realized he expected her to sit next to him. Beside him.

_On the couch._

"Dr. Carson, would you like a cocktail?" she said, "I apologize, I've only mixers, gin and vermouth. I'm completely out of red wine. I should have checked before inviting you over but —"

He shrugged, "I admit it's been a long while since I've had one but — if you wouldn't be terribly put out."

"Oh, not at all." she laughed, relieved. Moving to her small liquor cabinet she pulled out two martini glasses, a shaker, stirrers and scanned the shelves for the alcohol.

"I never would have guessed you were a martini drinker," he said, genuinely surprised. He watched in rapt attention as she uncapped the bottles.

"How do you like yours?" she asked, turning to look over her shoulder at him.

"Dry," he said, watching her expertly begin mixing their drinks as though it were surgery, as though it were the most natural thing — the most natural skill — in the world. "You're remarkably skilled at this."

"I admit I've had some practice," she said. "I don't know what _you_ did during medical school to make a dime or two, Dr. Carson, but you're looking at one of the best barkeeps' in Oxford. Well, thirty-some years ago anyhow."

"You — you were a _bartender _while you were at university?" he said, leaning forward.

"What else could I have done with the odd hours I kept?" she laughed. "I'd never been so exhausted in my life. I had more than a few nights where I confused my medical terminology with my mixology." glasses in hand, she made her way to the couch, setting his down on the coffee table and hovering above the couch with her own — extra dirty— in hand.

"Have a seat," he said, sliding over to make room.

They lock eyes. She inhales, disturbing her drink just slightly, just enough for a drop of gin to dribble down the side of the glass and onto her finger.

_He moves his fingers over her in widening circles, she feels her legs begin to stiffen and release just slightly, her hips bucking against his hand. Her breathing deepens and she presses his hand against the softness of her middle, implores him to feel how alive he's making her. His fingers lift suddenly and the disruption makes her protest — she whines, digs her heel into the floor, reaches for his wrist. He returns his finger to her, sliding his hand up along her warm belly to her breast, taking it in his paw and squeezing it. She lets her head loll back against his shoulder, feels herself breathing into the pleasure which advances and recedes, builds as he speeds up his ministrations. _

"_What then, Dr. Hughes? Where do we go from here?" he says through halting breaths._

_She's nearly there, her feet against the ground, her hands gripping the couch cushions as she feels her muscles begin to hold themselves in that pleasant tension, feels the dampness spread and the heat starting low and, like a flash of flame, rising up her chest and alighting her face with a pretty blush. She whispers, but swallows her words._

"_Tell me," he says, pulling her tighter against his body._

"_We come," she breathes._

"Dr. Carson, pardon me for one second — I — I have to make sure I turned the stove off." she moved to leave the room but he cleared his throat, asked her to wait.

She turned slowly, her hand gripping the door frame's molding.

"Do you remember Chrissy Newman?"

She blinked, her mind reeling. "I — she was — it was one of my first traumas. Summer of '88 I think." she furrowed her brow, "Why?"

"It was our first surgery. Together." he said, "I was thinking about it today."

"Any particular reason?" she said softly, trying to decide if her legs would support her if she crossed the room. If she went to him.

"I just — it was the only time I can remember seeing you cry, _really cry_, about losing a patient."

Elsie stiffened, "Well, Dr. Carson, she was four years old, her father had driven them both off the road because he was _drunk_—"

"Dr. Hughes, I'm not criticizing you." he said, "I only mean to say that — that perhaps you've not always expressed it in my presence but — clearly you possess great emotional depth and if you are — unraveled or frightened or angry about what's happening to you — I just want you to know that I would not be put off if you were to express those feelings in front of me. Like that day in the lockers — it would stay between us." He held her gaze a moment, then lowered them, setting his martini glass down on the coffee table. "Now, that's all I wanted to say about that so — why don't we go over the paperwork I've brought. Hm?"

His eyes were kind and she hesitated a moment, then let out a quiet sigh, taking a few steps toward him. She lowered herself down onto the couch next to him, resting her drink on the end table. When she turned back to him, she realized how close they were.

"_I'm not sure what I'm looking at, Dr. Carson." Elsie says, staring at the book he'd ceremoniously plopped down in her lap. He sighs wearily, leaning back into the cushions of her couch, reaching a hand around her to point at a passage he's marked._

"_A woman of medicine doesn't know a uterus when she sees one?" he teases, "Perhaps you need an anatomy refresher course." _

_She glances up to look at him; realizes how close he is. Her breath hitches, "I know damn well what it is, I just don't know why you're showing it to me?" _

_He smiles, his eyebrows wagging. "I need your clinical input." _

_She raises her eyebrows in response, "Oh?" _

"_Yes." he says, letting the hiss linger on his lips. "Can you explain something to me?"_

"_I suppose I can try," she says, and he scoots closer, his thigh pressing against hers, his arms pressing against hers, warming her. His mouth is just next to her earlobe as he speaks._

"_Define for me the phases of female arousal." _

"_What?" _

"_Female sexual response, Dr. Hughes. I need a proper explanation. This textbook is almost humorously outdated," he reaches down, into her lap, slips a finger into the crease and holds his place, flipping to the front of the book, pointing to the copyright, "See?" _

"Dr. Hughes," he said quietly, "If this isn't the right time, if this is too much for you — I mean you don't even know what you're up against here. Perhaps it's a bit preemptive to be deciding the fate of your body when for all we know it's perfectly suited to many more years in the mortal coil—"

"If it is cancer," she said quickly, "Would you stay — would you stay with me and — and help me?" worrying her lower lip, she lets her gaze fall. She can't look at him, not now.

"Of-of course I would," he says, putting a hand on her knee. She flinches, but not from fear or pain; something that quickens her heartbeat and gives her a the most pleasant rustling that rises from her stomach and blooms in her chest. "Say the word and I'll—"

He pauses. She lifts her gaze slowly, meeting his eyes. He's looking at her intently, trying to find the meaning in her words, in her silence. He blinks, gently takes back his hand, rests it awkwardly, unsatisfied, in his lap.

She lifts her own hand, deposits it in his lap atop his folded hands. He looks up at her, a half-smile tugging at his lips. His eyes lock onto hers.

"Dr. Carson, I —"

The room feels all at once empty, echoing; as though every motion and every sound is amplified. Her ears tingle, heartbeat racing to catch up with her pulse which fills her with hot blood that doesn't feel like her own. She buzzes and she's only had a sip of alcohol, so it's not that which has intoxicated her. She leans forward slightly, before she's fully thought about what she meant by it — but there is something that has lassoed around her and is pulling her, the room closing in and pushing them into one another's carefully carved out and protected space in the world.

Before she knows what's happened, the air in the room changes. Heavy, like ether. He stands suddenly, knocking the coffee table, tipping his drink over and it puddles, pouring onto the floor. He curses, lifts his hands in surrender; to everything — to so many things. His apology is mumbled, his voice cracking, and he heads for the hallway. She hears him hastily sliding his shoes across the floor as he drives his feet into them, whips his jacket from the coat rack, probably doesn't even get both arms into it before she hears the door close and his heavy footfalls growing fainter as races away from her.

A moment passes and then, she begins to shake.

And the room that was only moments ago filled with the answers to all the questions she'd never known how to ask became glaringly empty, except for the steady dripping of a spilled drink — and the decades-old sobs that had welled up in her finally flowing over.


	19. Scar Tissue

**A/N: Y'all made me feel guilty for leaving you hanging — here's a mini-chapter for you. :) Thank you for all the lovely reviews, your enthusiasm for this story continues to make me want to slave over it and make it the best it can possibly be. With, you know, plenty of DRAMA. So, feels alert on this one. **

* * *

Charles started his car, but let it idle. The BBC news program thrummed low as he gripped the steering wheel, leaning over and pressing his forehead against it. His entire body ached, his stomach turning — and perhaps worst of all, he was angry and disgusted with himself.

_He wanted her._

It was not some flight of passion. He'd been attracted to her all along, of course, remained attracted to her with each year that passed them by. But he_ respected_ her and would _never_ have presumed, never have pushed past propriety for his own pleasure.

They were intimate in the hospital, in the safety of its sterile rooms and cold, metal instruments and _always something to distract them. _Still, he _knew_ her, didn't he? He knew how she took her coffee. He knew her schedule. He knew the books on her bookcase, where to go for one that he needed. He had seen her rotate through the same pant suits, blazers and wool skirts for decades, watched as her hair began to shine with silvery strands. He knew what her favorite scalpel was (_10-blade, carbon-steel_), knew that she detested classical music while she operated because it made her sleepy.

He catalogued what he knew _now_: she could make martinis. That her apartment was warm and she had a basket of yarn in her entryway. That her toenails were painted plum.

_That she was afraid._

Sitting in his car, paralyzed in the driver's seat, his heart pounding in his ears, he realized that he had tucked these things away _not_ because he found her beautiful, _not_ because he wanted to know the softness of her bare skin against his; but because_ he_ _loved her._

In her living room, sitting on the couch, he saw her for the first time. Her hair was not as tidy. She was dressed simply, comfortably. And when she looked at him, her mouth parted slightly, her eyes the same eyes that had looked tearfully up at him in a humid locker room, had let him in — he knew, then, that he loved her.

And that there would be complications.

* * *

Two gin hot toddy's later, Elsie tangled herself in the covers of her bed, still in her clothes but too emotionally spent to change into her pajamas or take off her makeup. She hugged herself tightly, the feeling of her arms against her body comforting — but unsatisfying.

The knock at her front door startled her; she wondered for a moment if her slightly inebriated brain had imagined it. When the second set of knocks, she bolted upright. Easing herself from the bed, a bit unsteady as the room spun around her with gin and residual, heavy sadness she padded out into the hall.

When she opened the door, the force of it — or his form revealed from behind it — sent her stumbling back into the hallway. Steadying herself, she stared. Waited.

"I'm sorry," he said quietly. "I'm —"

"Your briefcase."

"What?"

"You're here for your briefcase and your —" she gestured exaggeratedly toward the living room, "Your papers."

He blinked; he'd not even thought of that.

"Well, come in and fetch them." she said quietly, folding her arms across her body.

"I didn't — that's _not_ why I came back." he said, taking a tentative step into her flat, pushing himself back against the door to close it. "I have — there's something I'd like to say."

He noticed then how exhausted she looke; how worn. And it wasn't from work, it wasn't from the liquor — the strong scent of which hung in the air between them. Her spirit was dampened and_ he'd_ done it. His stomach knotted and he let out of a shuddering breath.

She didn't move.

"I want to say something to you — and — and I don't know if it will hurt you. Or me. Or — or both of us or neither of us but . . ." his voice trailed off, losing momentum. His heart beginning to lose its courage. A heavy silence settled in between them. He prepared to run again, to turn his body and leave her, _really leave _this time —

"Isn't that what we tell our patients?"

He looked up when he heard her voice.

She took a step toward him, her arms still crossed tightly in front of her chest. "We tell them that _it might hurt_ — the injections, the surgeries — but that's the only way they'll get better. They come to us with broken bones, we set them. They're ill, we make them well. They bleed —" she paused, letting her eyes close, "— they bleed and we stop it. We give them back what they've lost. We — we give them back their heartbeat." her arms lowered, hanging limply at her sides, and she took another step toward him. "It might hurt — but it has to, in order to heal properly."

He swallowed hard, sighing over his words. "I care about you and — and I don't know why it's so difficult — to tell you that I care for you _very much,_ and I want you to know without a shadow of a doubt that — that whatever happens, whatever comes of all this — I will help you. I will be — whatever you need, do whatever needs to be done. But — you should know that — that I am afraid. Afraid of —losing you."

He met her gaze, held it. Waited — _and he would wait, he'd wait there all night, he'd stand there until the night turned over and lifted its face to the day_ — until she spoke.

"_I'm_ afraid," she whispered, so quietly he may not have heard her, but he saw her lips curl around the words, her fingers dabbing beneath her eyes. "I'm so afraid."

He saw her, then, almost thirty years before — standing in a locker room, letting herself collapse. She was younger, her face thinner, her hair lighter. And now, she stood in front of him trying so hard not to let go, holding herself together so that she wouldn't unravel, spiraling out into the universe. He saw how she trembled, how her muscles tensed the harder she tried to still herself, how she blinked hard against her tears — and he felt it, he felt the pain.

And that was what made him take another step toward her, wrap his arms tightly around her so that he could hold her together as she fell apart.

After a long moment, she pulled back, wiping her eyes.

"Now, that wasn't so bad was it?" he said quietly, squeezing her hand reassuringly before letting it go. Released from his tender grasp, she held it protectively to her chest, trying to retain his warmth.

"No," she said quietly. "It's very late, Dr. Carson."

"Right," he whispered. "You should get some rest."

"You as well." she said, letting her gaze fall. "I'll see you tomorrow?"

He smiled, reaching for the door knob. "You will." he said simply, "As always. With coffee — and perhaps aspirin and a bottle of water." he said, giving her a knowing look.

She laughed, reaching up to wipe her tear stained cheeks. "Goodnight, Dr. Carson."

He turned to smile back at her as he opened the door, "Goodnight, Dr. Hughes."

* * *

Putting her iPhone on its dock, Mary turned up the volume and nodded approvingly when a playlist of dubstep remixes came on. She pulled her Mac onto her lap, already hot against her bare thighs (_it was late, she lived alone — if she wanted to run about in her panties and a tank top who was to discourage her?)_ and opened a new tab.

She typed "_Dr Lavinia Swire_" into Google and hit enter.

"Oxford educated. Pediatric neurosurgery. Pioneered techniques —_blah blah blah._" Mary said, reaching for the pint of gelato she'd settled on for dinner. Spooning a taste into her mouth, she went to the next page of search results.

Something piqued her interest, then. She leaned in to read the headline again, just to be sure.

"St Mary's Surgeons Swire and Crawley Dazzle At Annual Gala!"

Clicking the picture she gasped, the spoon falling from her hand and clattering across her keyboard; lime gelato gone everywhere.

_Matthew knew her, _she thought, looking at the photo that accompanied the article from the hospital's newsletter. Not only that but, judging by the adoring looks on their faces — he knew her in more ways than _one_.

She huffed, clicking out of the window and moving to wipe up the gelato. Why did she even care? It wasn't as if Dr. Swire was any kind of threat to her career.

So why did she suddenly feel a sting of jealousy at simply the_ thought_ of her?

* * *

Robert slid in to bed next to Cora, his brow deeply furrowed.

"You didn't eat any of your dinner — not even a cup of tea." he said, leaning down to kiss her shoulder, "Are you ill?"

"No, Robert. Only tired." she said dully, staring at the digital clock on her nightstand.

"Are you still upset about Mary?" he said, settling back against his pillows. "Darling, why-ever she's cross, I'm sure it really has nothing to do with us. Nothing to do with the baby. You know how Mary can be."

"But why, Robert?" Cora said, her voice heavy with exasperation. "Did we do something to make her that way? To make her_ so_ —"

"Even as a child she was —" Robert laughed bitterly, "_Direct._"

"Sometimes I —" she paused, losing her voice. She turned to face him, her face sallow from crying and her eyes heavy. "I don't think she loves me."

"Cora," Robert said quietly, laying a hand gently on her middle, "Of course she — you're her _mother!_"

"I don't know what I did wrong —"

"Cora, darling —"

"She was the first, yes. I was young I was — I was_ nervous,_ it was all new, but I did everything I thought — that I thought to do. I — I loved her Robert and _I do_ and I — I don't know what — what I —"

Her tears cut in and she curled against him. He rested his chin atop her head and embraced her, rubbing her back soothingly. "Mary loves you, darling. I know she does."

"She loves _you,_" Cora said, her voice warm against his bare chest. "She respects_ you_."

"Oh, darling, I—" he paused, realizing he didn't have much prepared to defend Mary. He had no go-to argument to convince his sobbing wife that their eldest daughter loved her; he was without testimony, without evidence. And he knew, to Cora, it had to be more than blood. Blood wasn't proof of anything, except that a person could bleed. And she knew that without being told.

"I don't know," she said as her crying began to subside. "Maybe I'm just overreacting."

"Let's go to sleep," he said calmly, "Everything will look brighter in the morning."

She gave him a look, her lips curling up into a half-smile that was nearly a wince at his saccharine attempt at comfort. But she leaned up, kissing him softly.

She wasn't about to refuse a little sweetness.

* * *

Isobel turned the lock on the door to Dr. Clarkson's waiting room, reaching for the light switch; out of the corner of her eye she saw a figure move in the darkness and she froze.

"Isobel, leave the light on for me, would you?"

She exhaled.

"Certainly, Dr. Clarkson — I didn't know you were still here."

Appearing from the darkened hallway, he smiled sheepishly. He looked entirely exhausted, leaning against the entryway, his head hanging forward as though he'd lost the motivation to maintain a straight spine.

"I've just — I've been working."

She paused, letting her hand fall from the light switch. "Anything I can do to help?"

"No, no." Dr. Clarkson said, "You should go home. It's late."

She laughed, taking a step back into the waiting room. "Yes, but if I leave who will be here to tell _you _it's time to go home?"

Dr. Clarkson smiled, laughing sadly. "Well — perhaps you can send me one of those text messages if it gets too late."

"I will,"

"Oh, Isobel — I was only kidding —"

"I will text you at nine o'clock. If you're still here, take it as your cue to go home."

She smiled, turning back toward the door. "I'll leave the light on for you, Dr. Clarkson. Good night."

"Good night, Isobel." he said, watching her leave. As he turned to walk back down the lightless hallway toward his office, he paused, patting his shirt pocket; smiling to himself when he felt the shape of his phone beneath his fingertips.

* * *

"I'm on call, so, I can't imbibe." Tom said, shaking his head as Sybil offered him a swig of her beer.

She nodded toward his rig, which was parked a few driveway's lengths down the street.

"Right, can't have you endangering the public trying to. . .well, _save_ the public." she plopped down on the front steps of her parent's house, gesturing for him to join her.

"Are your parents still up?"

Sybil snorted, "Would I be walking around with a beer in hand if they were?"

Tom shrugged, sitting down next to her. "It's not like it's illegal or anything."

"Yeah, well, they have higher expectations for me than this. I'd hate to be a disappointment."

She reached into her coat pocket and pulled out a pack of cigarettes. Tom raised an eyebrow, somewhat delighted with the rebellion, but shook his head when she offered him one.

"Is it ever— I don't know— kind of hard to be_ Mary Crawley's_ little sister?"

Sybil laughed. "Only when she's being a bitch." she said, the cigarette bouncing against her lip. She reached up to light it, taking a long drag, then stuffing the pack and her lighter back into her pocket. "I think it would be harder to be in Edith's place."

"She seems so nice, though. Quiet, maybe a little — I don't know, _skittish_ at times. But she's really smart and very funny. I don't know why everyone kind of _ignores_ her."

"Even my _parents_ ignore her," Sybil said, "If I wasn't — oh, what did mum call me the other day —_ spirited!_, well, they'd probably not notice me either." she hugged her coat tighter around her shoulders, "I might cause a few uproars a year but nothing that hurts anyone, I don't_ bully_ people like Mary."

"What's her deal, anyway? Why is she so pissed about this baby thing?"

Sybil shrugged, "The only thing I could think of was that, I don't know, she's _jealous_ or something. Because she's like, you know, a grown woman and not married and, I don't know, maybe her biological clock is ticking."

"More like it _exploded_," Tom said, "Your mum must have been really upset."

"Mum's tougher than she looks — but yeah, Mary's just. . .I don't know." Ash fell from her cigarette on to her jeans and she wiped it off, shaking her head sadly, "But like — it's kind of nice that my parents still love each other enough to have sex. Like, it's _gross_ 'cause they're _my parents_ but like, at least they're not old and bitter in their marriage."

"Maybe that's what irks Mary so much."

"What— that they're getting laid more than she is?"

"Well —_ that_ but, also, that they're happy."

"Guess she'd better get used to it," Sybil said, reaching around Tom for her beer. "The only thing that has kept my dad's life from being perfect is a son — and now he's getting one."

"Are you gonna miss being the baby of the family?"

Sybil snorted, choking momentarily on the sip of beer she'd taken. "_Fuck no_! Maybe they'll finally start treating me like an _adult_."

* * *

Rosamund slipped into the tub, wine glass in hand, and sighed deeply. Oh, she _needed _this. She _deserved _this. The last 72 hours had been what could only be termed a _clusterfuck _and she was more than ready to turn off her pager, her phone, lock her door, put on some jazz and let the world spin on without her for an hour or two. So when her cell phone jingled from the sink countertop, her audible "_fuck!" _rang out through her apartment. She almost didn't answer it. Almost let it go to voicemail. But when she glanced at the screen and saw the number, her heart stopped. Her mind had tried to forget the number, the person attached to it, but had failed miserably.

She set down her wineglass and shakily reached over the edge of the tub to answer the phone, sliding the screen lock open.

"Hello?"

"Rosamund?"

His voice. Unchanged, even after all this time.

"John," she breathed. "John, why — _why are you_ —?"

"You called _me,_ Rosamund." he said, laughing uneasily. "Left me a rather distraught voicemail. I — I left it, wondering if you'd call me back. Say it was nothing but drunken rambling. But you didn't. So. So I'm calling to — to make sure that you're okay."

"You shouldn't have called me."

"Well — Rosamund, I couldn't just —"

"I was drunk, I admit — I don't remember making the call."

"If you check your call log I'm sure you'll see it. Or I can just play the message for you."

Rosamund winced. She'd been drunk, yes, most of the weekend in fact – and whatever she'd said she was sure she'd want to forget.

"I haven't called for any other reason than to be sure that you're alive and — well, that everything is okay." he said, his voice gone quiet.

"I am alive, John. Mortified beyond reason. Willing myself _dead_ at this moment, knowing that in my drunken stupor I've humiliated myself to this extent."

"If it makes you feel better, I maintain that you are always _equally_ as charming drunk as you are sober, Ros." John said. "A bit of tipsy truth suits you."

She smiled in spite of herself. _God damn you, John Foyle_, she thought. _God damn you making me feel something. _

"Well. . .how is Tony?" Rosamund said, "Still in London?"

"Ah — yes. He's done quite while. President of Gillingham &amp; Green Pharmaceuticals."

"Oh," Rosamund said, "We get their reps from time to time."

"Yes, he's — he's _very_ familiar with Downton."

Rosamund stiffened, "Familiar. . .how?"

"Not familiar like. . .about any of that." John assured her, "He just — well, he goes out there on occasion. For work. In fact, I believe he'll be there this Friday, for the Gala. You'll see him, I suppose."

"It's been a long time. The last time I saw him he — he was just a boy. A_ teenager_, maybe. How would I recognize him?"

"Well, —" John said, "For one, he looks just like _me._"


	20. Metachronous

**A/N: Time jump but just a little one! Inching closer to some major plot developments. This one is a little fluffier, good news abounds! Well, for some. Notes at the end because some of the medical stuff is a bit confusing. Thank you for your reviews and love here and on Tumblr, I can't believe we're 20 chapters into this saga and still going strong. You are all amazing and I love writing this story for you _boobies. _**

* * *

While Dr. Carson had made good on his promise to deliver aspirin and coffee to Elsie Tuesday morning, she hadn't crossed paths with him again until Thursday afternoon. The arrival or Dr. Swire had sent everyone into a tizzy; whenever a new staff member arrived at Downton the hospital went on the offense. Any "outsider" had the potential to identify areas of weakness within the organization, and while Elsie never considered that inherently _a bad thing, _there were certain administrators and even physicians who detested even the mere _suggestion _of change*. And historically, Charles Carson had been one of them.

So, when he appeared in the doorway of her office just as she was about to leave it, she paused.

"Long time no see, Dr. Carson." she said.

"Yes, I know. What a _bizarre_ week it's shaping up to be."

"I suspected you'd be holing up somewhere until the storm passed," she said, slipping past him through the doorway, "I'm on my way to see Dr. Clarkson— walk with me?"

"Oh—erm, yes." he said, "For your results?"

"Yes," she sighed handing him a chart. "But let's not talk about that just now. Have a look at this chart, Stephanie—the astrocytoma."

"Right —so you've properly met Dr. Swire I take it?"

"I have," Elsie said, waving to Anna as they passed the nurses' station.

"And your first impression?"

Pausing as they stepped into the main hallway, Elsie pursed her lips "Very _young_. Very _smart_ — and wears _far _too much perfume for a surgeon."

"Hm," Charles said, furrowing his brow, "I'm sure someone will mention it eventually. If it's truly _problematic_."

"I think we both know of a certain Dr. Crawley who isn't afraid to tell off another doctor when it's warranted; or even, perhaps, just when she feels _inspired_."

"Mary's intense but she's _not_ cruel,"

"_Hm_," Elsie hummed non-committally, "Well, anyhow, I don't think Dr. Swire's penchant for bathing in _Chanel No. 5_ will negatively impact her ability to extract the tumor from my patient; however, since the girl _is_ in my charge, I was hoping I could convince you to scrub in and assist."

Charles looked up from the chart, "I — well, I _suppose_ but — well, don't _you _want to?"

"It's scheduled for early next week and I don't know if I'll be _otherwise engaged_, Dr. Carson" she said quietly.

"I see," he said, realizing the implication. "Of course. I'll plan for it."

"Thank you," she said, taking the chart back from him and tucking it against her chest. "Have you not met her yet? Dr. Swire?"

Charles shook his head, "Not formally, no. Seen her coming and going from the operating suite but we've not spoken directly. I suppose I'll meet her at the gala."

Elsie stopped short, staring up at him. "Charles Carson, do you mean to tell me that after more than _twenty-five years_ of begrudging the annual Downton Hospital Gala, you are planning to be in attendance with— shall I venture—_bells on_?"

Charles flushed, "Well — I — I just figured I_ might as well_—" he sputtered, his hands waving nervously in front of his body until he eventually gave up and just stuffed them in the pockets of his white coat. "You always go, don't you?"

"I do," she said, her voice measured and low as they stepped into the hallway leading to Dr. Clarkson's office.

"Well, that's reason enough for me. To — to think it's worth my time."

She smiled, "I hope you're not disappointed," she said, "It's a long night with terrible music, lots of sparkling attire and, in my opinion, catering that is a _barely _a step above what we'd get in the canteen."

Charles chuckled, "But there's an open bar, yes?"

"_Oh yes_," Elsie laughed, pausing outside Dr. Clarkson's office door, "It makes the evening tolerable."

"Well, that's all I need to entice me," he said. A moment passed between them and he realized that he should turn and go — leave her to her appointment. Part of him very much wanted to stay. Part of him wanted her to ask him to stay.

A rather large part of him _wanted her to want him to stay._

"I'll let you know," she said softly, "I promise. I'll not keep it from you."

"Thank you," he said, exhaling. "I'll — well, I'll be in my office. I haven't any more surgeries today. I have one patient I'd like to check in on but — well, I'll do that now and then — find me as soon as you're done?"

" I will Dr. Carson," she said, her eyes soft.

He watched her turn and disappear behind the door to Dr. Clarkson's office and he wished he'd managed to say something. He wasn't sure what he'd've said: all he knew how to do was offer up meaningless platitudes in situations like this. And for patients that was all that was of expected of him.

But what did she expect from him? What was he expecting of _himself_?

* * *

"I was fitted for this _weeks_ ago — if I even look _remotely_ pregnant I'll have to get something else." Cora said, turning so that Sybil could sip up the back of her gown. It was beautiful, of course; floor length cobalt and black, the same elegant, simple style she wore every year to the hospital's gala. It was far too late, really, to get another dress — but if necessary perhaps she could borrow something from Rosamund. . .

"Mum, — it looks _fine_. You look totally _flat._" Sybil huffed, sitting down on the edge of Cora's bed.

"You're sure?" Cora said, turning sidelong to her full length mirror and pressing her hands against her middle, "You're _absolutely sure_ you can't tell?"

Falling back on the bed with dramatic frustration, Sybil groaned. "Mum — you _don't look pregnant,_ really. If you were wearing something totally tight-fitting than sure, _yeah,_ they'd probably notice but they'd just think you've gotten fat."

"_Do_ I look fat?" Cora pouted, turning toward her.

"No, mum — _j__eeeeee-hu-sus_!" Sybil laughed, covering her face with her hands. "You look gorgeous. You look gorgeous _every_ year. You show up on Dad's arm and make him look like a real winner. And it's the same shit every year, all the male interns and residents have too much to drink and they shamelessly hit on you. Because you're a total MILF —"

"A _what_?"

"A MILF." Sybil said, sitting up. "You know — a _Mother I'd Like To Fu_—"

"Sybil!" Cora breathed, "That's _vulgar._" she turned back to the mirror and adjusted her hair, then whispered naughtily, "But I _love _it_!" _

"I freakin' love _you_," Sybil said, hopping up and going to the mirror, fluffing the skirt of Cora's dress. "What about shoes?"

Cora cringed, "I guess I'll have to wear heels."

"Eh, that's alright. By the end of the night we'll all have taken 'em off to dance."

"Well, not me. I'll probably fall asleep by 9 o'clock."

"Oh man, and you can't _drink._ We'll have to come up with a non-threatening health crisis for you."

"No one will notice if I don't drink," Cora said suspectly.

"_Mum_ — last year you almost let those interns convince you to do body shots. _Everyone _will notice if you're not drinking."

"_First of all,_ I had _no_ idea what body shots were and I was only trying to be _polite,_" Cora defended, "And secondly," she sighed, "Well, maybe it wouldn't hurt to have an excuse handy."

"Just tell them I'm giving you an ulcer."

"Oh, _Sybil_!" Cora laughed.

"I'm serious — just tell them I'm a _massive_ disappointment, _sullying_ the Crawley name with _alarming_ speed and it's given you a gastric ulcer. So you _can't_ drink." she wrapped her arms around Cora in a tight hug and giggled, "I'll even misbehave all night long to convince them it's true."

Cora pet Sybil's cheek affectionately, "You'd do all that for me darling?" she teased.

"Well, not _just _for you." Sybil said, resting a head on Cora's shoulder. "If I've got to go to this stupid thing I've got to keep myself entertained somehow."

* * *

"Pet, if your father wasn't the CEO of this hospital you wouldn't _have_ to go, but, as it stands, _he is_ — and you _do._" Rosamund said, mindlessly chewing on a pencil as she and Edith went over charts in her office. The week had been tense and Rosamund had enough grating down her nerves without Edith's whining; she loved the girl as though she were her own child, but sometimes that meant her patience with her wore _preciously_ thin.

"No one would even notice if I didn't go," Edith reasoned, recapping her pen and tossing it down onto Rosamund's desk.

"_I'd_ notice," Rosamund said, removing her glasses and leaning forward, "Edith — if I tell you something will you _promise_ that it will stay between us? I think it has the potential to make the gala more than worth your while."

"Of course," Edith said, intrigued.

"John Foyle's son —"

"Tony, I know. Mary and I went to uni with him."

"Yes, well, he and his — well, I don't know, _business partner, _Mr. Green, I don't know him, anyway they now operate Gillingham and Green Pharma — you know, we get the reps from time to time."

Edith groaned, "Oh, Tony's gone to the dark side, then? What a shame, he was a nice guy — even if his father was a —"

"No commentary on his father, that's not what this is about." Rosamund said firmly, "But, _Tony_ will be at the gala tomorrow night."

"Oh," Edith said, her eyes wide. "Does Mary know?"

"No, she doesn't. No one does except for you and me. And I have no intention of mentioning it to anyone else, and I would hope that you won't —"

"I won't,"

"Good."

"Why would you tell _me,_ though?"

"Well, darling, he'll probably speak to you and Mary and — well, I thought I'd give you a bit of a head's up. You know, since he'll ask what department you're in, and inevitably _my_ name will come up and —"

"Why would he even come here? I mean, I know he didn't have anything to _do_ with his father's behavior but, still, it's not like he doesn't _know_ what happened."

"Pharmaceuticals, darling. It's a ruthless business. There'd be no way for him to sidestep contracts with Downton. It would cost him his career."

"Well, I suppose that's true." Edith said, fussing with a hangnail. "You're hoping he might mention John, aren't you?"

"What — to _you_?"

"Yeah," Edith said, looking up at her quickly, then lowering her gaze back to her fingernail, which had begun to bleed. "Do you want me to ask about him or — or just wait to see if it comes up?"

Rosamund didn't say anything, but Edith could hear her breath quicken.

"I know I've been rude about — _about what happened with him_ but — if you just want to know how he _is_—"

"I _know_ how he is, Edith." Rosamund said quickly. "How do you think I knew about Tony?"

Edith considered this a moment, then brought her bleeding thumb to her lips, soothing it gently.

"I don't need to know _anything_ about John." Rosamund said levelly, "But, if Tony is anything like his father, he'll probably make a beeline for Mary." she put her glasses back on eyeing at Edith from overtop them, "And if he's anything _at all _like his father, we've _got_ to keep him as far away from her as possible."

* * *

"But it's _not_ cancer?" Elsie said levelly, eyeing Dr. Clarkson as he turned the computer monitor toward her.

"Not explicitly, _no_," he said, "But these tumors, phyllodes*, can get quite large and even if they remain benign in the sense that they're not _cancerous_, I wouldn't suggest you leave it."

Elsie squinted at the image he was showing her on the computer screen. "It's embedded in the connective tissue as well?"

Dr. Clarkson nodded, "That's what they do; they're in mammary _and_ connective tissue, and as they grow they stretch those tissues and it can be quite painful. Not to mention deformative."

Elsie scoffed, "Well, I hardly care about how it_ looks_, Dr. Clarkson."

"But it is likely to hurt —" he said carefully, "If. . .if it is_ touched,_ even lightly, or pressed against. . ." he gave her a stern look. It took her a moment but then it registered.

_If a partner touched it. _

"Dr. Clarkson we've known one another for many years and _I_ know that _you_ know there is no man in my life to disrupt it." she said, her cheeks pinking up. "If you're saying that it is nothing more than a nuisance or a cosmetic consideration, I don't think it's worth removing it."

"There is still a chance it _could_ be borderline, Elsie." he said, "I would feel better as your physician and as your _friend_ if it was removed; and removed with a wide margin. Then we can be _absolutely_ certain."

She narrowed her eyes at him, "You're not just swaying statistics in order to intimidate me, are you Richard? Because if you are, I will find out and I will be _very_ pissed."

He chuckled, "No, Elsie, I'm not. I'm just saying — there's no reason _not_ to have it removed. It doesn't belong there. It's no more than a Day Surgery unless —"

"Unless what?"

"Well, if it's very involved — and, not all the tissue can be removed, sometimes they grow back and —"

"I'd insist on having the best surgeon perform the lumpectomy, then; be sure that I've only to do this _once._"

There was a silence between them while they both tried to decide how to broach the topic of _which _surgeon at Downton would be tasked with performing it — now that she'd apparently passively agreed to it.

Of course they both knew who the best surgeon at Downton was, but neither wanted to be the one to suggest it.

Finally, Elsie sighed, shaking her head in surrender.

"He'll do it if I _ask_ him to," she said quietly.

"Oh, no doubt." Dr. Clarkson said, "As your physician I can certainly refer—"

"Regardless of whatever paperwork you complete, the charting — this has to be a conversation firstly between Dr. Carson and myself." she said, her voice small and tight in her throat as she tried to keep it steady.

"Understood," Dr. Clarkson said, folding his hands in his lap. "So — will I see you at the gala tomorrow night?"

She laughed, groaning. "Aren't we getting too old for this?"

"I don't know, I always like watching the interns make fools of themselves."

"You can do that in the hallways or the emergency department any time of the year," Elsie said, grabbing her purse and sliding it over her shoulder. "But you know I'll be there."

Dr. Clarkson laughed, leaning back in his chair. "One of these years we ought to break out the tartan in opposition to the sequins and lace."

At this, Elsie guffawed — and it felt good to laugh, really giggle.

She turned back to him as she opened the door to his office to leave, "Thank you, Richard. I really needed that."

* * *

"It was just a routine surgery, wasn't it? Why can't I go home?"*

Charles sighed, pulling a chair over so that he could sit next to the patient's bed. She was young, late twenties, very pretty — clearly someone in good health other than her gallbladder, which had graciously been removed, and some mysterious hypotension that they couldn't seem to control.

"Breanna, I know this isn't how you planned to spend your week but as you recall, your blood pressure hasn't stabilized well post-operatively. Until you're able to stand up and move about without it dropping, we can't send you home. We have to know _why _it's going so low and correct it." he reached over to pet her hand reassuringly, mindful of the IV that had been threaded into the only palpable vein on the top of her hand. "We can't have you fainting all over the place."

Breanna sighed. "Seeing as I'm still pretty sore from the surgery, I appreciate that."

There was a knock on the door and they both looked up. Charles couldn't help but smile when he saw Dr. Hughes standing there, looking relaxed and calm, which to him meant the news she had to share was _good. _

"I'm sorry to interrupt," she said, stepping into the room.

Breanna furrowed her brow at Dr. Carson, who was staring somewhat unabashedly at Dr. Hughes. Not knowing who the woman was, she could only assume.

"You must be Dr. Carson's wife," she said brightly, "If you've come to steal him away from lunch I can hardly keep him _here_—" she flicked her eyes up at Charles, who had begun to dab sweat from his brow nervously. "I promise not to get out of bed unassisted, Dr. Carson. I won't faint more until you come back."

Elsie smiled, looking down at her hands. "Um — well, that's very considerate but I'm _not_ —"

"I'll be back to see how you're doing this afternoon," Charles said suddenly. Elsie blinked, startled that he'd spoken so loudly even though they were all in close proximity.

"I'll be here," Breanna sighed, returning to her book. "It was nice to meet you — ?"

"Dr. Hughes," Elsie said, nodding.

"Oh," Breanna said, her hand hovering over her open book. "I'm sorry, I thought —?"

"No need to apologize, pet." Elsie laughed, "Dr. Carson is an excellent physician, so I ought to be flattered, right?" she gave her a small wink and then turned to Charles. "Do you have a moment?"

He stuttered, following her out of Breanna's room and into the hallway. "So — so is everything. . .?"

"Yes," she said, but her face contorted with worry. "But —"

"Oh God,"

"No — no, no. It's _not_ cancerous. It's just —"

Her pager buzzed angrily in the pocket of her white coat. She silently cursed it as she stuck her hand in to grab it.

"Oh — I'm sorry, I've got to take this but — well, find me before you leave for the day."

"Alright," Charles said, his throat suddenly dry, voice cracking. "But — um, Dr. Hughes?"

She'd already began to step away from him, but she turned. "Yes?"

"Are you still planning to attend the gala tomorrow night?"

She nodded, "If only to make sure Richard Clarkson doesn't get drunk and start rallying for Scotland's independence—"

"_Again_," Charles said, running a hand through his hair nervously.

Elsie chuckled, her pager beeping again, "I'm sorry I –"

"We should go._ Together_." he blurted. "I mean — not — not together just, together-_ish._ If we went in the same town car than we could leave at the precise moment it became too ridiculous to endure and we would have the perfect escape route."

She smiled, her eyes sparkling. "That's a _brilliant_ idea, Dr. Carson." she said, bouncing slightly on her heels as she turned, heading down the hall away from him. "Oh, and about your patient — the hypotension is _probably_ from the morphine."

He nodded, watching her until she disappeared around the corner. _Why didn't he think of that? _ Shaking his head slightly, he took off in the opposite direction, fighting against the smile that tugged almost painfully a his lips.

* * *

"John, _pleaaaaase_." Anna whined, "It's the only chance I have to wear something besides scrubs."

"It's a glorified grown-up _prom_," he said, reaching into the bag of potato chips he was working on as they sat in the lounge, having lunch. "It's just a reason for Robert Crawley to show off his family and ask for money."

"He doesn't need to throw a gala for _that_," Anna said, curling her lips around the straw she'd stuck in her milk carton.

"If I go, I have to anesthetize myself," he said, popping a chip into his mouth.

"There's an open bar," Anna offered, "Isn't that enough social lubrication?"

John scoffed, "_No_ — but, I suppose if you'd be with me . . . looking impossible gorgeous and forcing me to dance. Don't try to trick me, I _know_ that's your master plan and I already have planned to concede."

Anna squealed, leaning over to kiss his cheek. "So you'll go?"

"I guess," John sighed, "Maybe we'll get a glimpse at Cora."

"Do you think she's really pregnant?"

"Why would someone make it up? If someone wanted to start weird rumors about the Crawley's I'd think they'd lay it on Mary."

Anna nodded, "They're so cute."

"Who? Robert and Cora?"

"Yeah," Anna said, wiggling a bit as she set her milk down and stole a chip, "Every year they play _She's Always a Woman, _and wherever Robert is milling about and schmoozing, he finds Cora and they dance together. And they always dance the first and last dance of the night together. I don't know, it's sweet."

"Well, if she _is_ pregnant I guess that means there marriage is still — you know."

Anna giggled, looking at him longingly. "I_ miss_ you. . ."

"Are you off Saturday?"

"Mhm,"

"So you could come home with me,_ after_ the gala . . ."

"What about Sunday?"

"I'm on call, but we can risk it."

"I can't wait," Anna said, catching sight of his watch. "Oh — I've got to get back." she kissed him squarely, "Text you later?"

"Yes – even if it's just that stupid dolphin emoji. Just so I know you're thinking of me."

"_Always_," she said, biting down on the straw in her milk carton as she sashayed out of the lounge.

* * *

"You paged me?"

"You bet your _bippy_ I did," Beryl huffed, coming round the corner of the nurses' station, pointing toward the patient rooms. "You've got two patients causing a scene."

Elsie smirked, "I suppose I should be pleased they're feeling well enough to _do_ so."

"On a personal note, I happen to _enjoy_ the fact that they are passionately vocalizing the smashing of the patriarchy at this _fine institution of healing_ — but I've got little ones trying to sleep and irate parents, so if you would — _relocate their efforts, at least—_ I would be deeply grateful."

"Oh _alright,_" she said, setting some charts down on Beryl's desk.

"I also just wanted to know what Dr. Clarkson had to say?" Beryl asked quietly, looking sheepishly down at her coffee cup.

"It's not cancerous, but he'd like me to have it removed."

"_Here_?"

Elsie through her a look. "Where else but the best?"

"Yes, but would the best _do_ it?"

"If I asked him —"

Beryl snorted, "No, _of course_ he would, love — but have you stopped to consider the fact that it might_ rustle his jimmies_ to see your _funbags_?"

"Beryl Patmore! Good God. As long as he's not too rustled to perform a wide excision lumpectomy, _I don't care._"

"You're a _pathetic_ liar," Beryl laughed.

"He wouldn't _see_ anything — you know what sterile draping is like, he'd see about a _square_ of flesh, if anything."

"He might get a glimpse of a nip—"

"A glimpse, _maybe,_ but he's a consummate professional. Besides — can you imagine him checking in on me post-op and saying, "_Oh, by the way Dr. Hughes, nice tits_!"

They both laughed at this, and some dejected looking parents looked up at them from across the room. Elsie immediately quieted, feeling a bit of a cad.

"I should go check on our mini _Margaret Thatchers_."

There was a distinct rustling, then clattering of tools from a cart parked against the wall next to the nurses station and both Beryl and Elsie turned. Bending down slightly, Elsie peeked around and saw two pairs of eyes looking back at her.

"Or not so much _Margaret Thatchers_ as _Miss Marples,_" Elsie said, putting a hand on her hip, "You two _do_ realize that even though you're in pediatrics you're both about ten years too old for this _particular_ brand of shenanigans?"

Sliding across the floor, out from behind the medicine cart, Stephanie blushed, turning to help Samantha stand. Both looked a little pale and unsteady, but their eyes were bright with mischief and recaptured youth.

"Just so you know, we totally weren't _trying_ to listen to that conversation," Stephanie said.

"I kind of wish I hadn't heard it, to be honest." Samantha said, stifling a laugh.

"But since we _did_, you should know that if he _does_ see some boob, it's_ totally_ fine —"

"Yeah, as long as he doesn't see any_ nipple_—"

"Then it's only _PG-13 booby*._" Stephanie said, "There's, like, a spectrum of how much tit you see before it's weird, and like, if it's only side boob–"

"If it's a surgery or something it's probably just_ side boob_, right?" Samantha asked.

"Yeah, totally." Stephanie said, "Like, that's not even _that_ much. It won't make things weird."

Samantha nodded earnestly. "Totes not weird."

Beryl and Elsie just stared at them, mouths agape, until Beryl finally had to sit down in her chair and lower her head against her desk, her shoulders shaking with laughter. When she raised her head again, her face was damp with tears and she was snorting against her hands, which she'd pressed against her mouth.

"Back to your rooms, you _both_ need to rest." Elsie said, swallowing her own laughter as she watched the parents eyeing her from across the room again, "Don't make me regret introducing you two."

Both girls saluted her and spun on their heels, tittering as they dragged the other down the hallway. Elsie paused before looking down at Beryl, knowing if she did she wouldn't be able to keep from bursting out laughing.

"I am going to my office," she said evenly, "Do not page me unless someone is _dying_ or otherwise _decompensating_ — or if those two throw over the monarchy."

Beryl gave her a wave and wiped her eyes, trying to catch her breath. Elsie turned, walking down the hall to her office, shaking her head.

Sometimes laughter truly _was_ the best medicine.

* * *

* This is a big reason why the U.S. healthcare system is such a mess, actually. So, maybe not the case so much in the UK, I don't know, this was just my jab at American healthcare #shotsfired

* No one spells this the same, sometimes there's an 'i' in there, sometimes not. Meh. These _can _be cancerous. Sometimes they're benign. Sometimes they're borderline. The treatment's the same no matter what — just take 'em out, with a "wide margin" — anyway, I'll save the specifics for subsequent dramatic chapters.

* Hi breanna-louise!

* This entire conversation came from my actual life, with an actual friend, who I accidentally flashed one time and he said, "It's fine, it was only PG 13 booby" which somehow made us wind up having a conversation about what constitutes PG13 booby, exactly.


	21. Sequelae (aka The Gala)

**A/N: Hi guys! Oh, here we go. THE GALA. Trigger warning for some major violence. Also this really requires a soundtrack, which I compiled, and you can listen to here _( user/drchatelaines/playlist/53DvfMb9A0WWvOiAFl6MlP). _**

**Also, just a brief note to the anon who may or may not know my identity: please, please, please don't out me. If you do I'll have to leave the fandom. It's not because I'm worried about you guys knowing who I am so much as my career being threatened. I know you guys already are well aware but lots of people in publishing, etc. really look down on fanfic. I'm trying to stay anonymous because even though I think it's ridiculous that people shit-talk fanfic, because of the industry I'm in and some aspects of my career at present, I don't want to open up that can of worms — see what I mean? So, anyway, this is one hell of a chapter. I hope it moves fast, though, I think it does. It took me a long time because I haven't been feeling well. I imagine it could have been better but I think it's the game-changing chapter we've all kind of been waiting for. . .thank you again for all your love and support for this fic. I am continuously bowled over by the respon**se!

* * *

"The car will pick you and Sybil up at 6 o'clock," Robert said, reaching for his briefcase. "I'll meet you at the drop off and we can walk in together."

Cora smiled absently, stirring her tea. "That's fine, darling."

"Your lack of enthusiasm concerns me_ deeply_." Robert said, "What's bothering you? You _love_ the gala!"

"I'm just . . . _worried_."

"About?"

Cora sighed, "I don't think I'm ready for the _entire hospital _to know about the baby."

Robert blinked, "Well, _I_ wasn't going to say anything."

"I don't think we'll have to, darling. You know how Downton is."

"No one's going to say _anything_, you'll look gorgeous —like you do every year —and we'll talk to everyone, I'll have a bit too much to drink —"

"Like you do _every _year,"

"Precisely," he said, leaning down to kiss the top of her head. "Don't fret about a thing. It will be a marvelous evening."

Unconvinced, Cora shrugged, sipping her tea. Just as she heard the front door close with Robert's leaving, Sybil's footfalls lumbered down the stairs.

"You're up early, sweetie." Cora said.

Sybil yawned, groggily searching for a coffee cup. "It's Friday."

"I _know_," Cora laughed.

"I've got to get ready for the gala!" Sybil said, pouring herself a large mug of coffee.

"We're not leaving until 6 o'clock tonight!" Cora laughed, "That's about _twelve hours_ from now."

"Nowhere _near_ enough time. . ." Sybil sighed, plopping down at the table across from her mother.

Cora smirked, "Let me know if there's anything you need help with. I've got some earrings you can borrow."

"Actually, yeah — can I have a look after breakfast?"

"Of course, darling." Cora said, staring into her teacup.

"Mum, chin up. No one's gonna figure out your _dirty little secret_."

"Blame the hormones," Cora sighed, standing up to return to the stove to warm her tea.

Sybil chuckled, "Hormones or not you're neurotic as _hell_, mum. But we love you anyway."

* * *

"Where's Stephanie?" Elsie said, hovering at the nurses' station. Beryl flicked her gaze up from her computer screen.

"In pre-op—where else would she be?"

"Wait — _why_? Dr. Swire wasn't going to schedule —"

"It's _right here_, scheduled for 8 am." Beryl shrugged, "Naturally I assumed you _knew_ that."

Elsie furrowed her brow, "I most certainly _didn't. _When we spoke she said she would schedule for early next _week._"

"Well, it's in the computer, might as well be the word of God." Beryl said, squinting at the chart. "Also — why is _Dr. Carson a_ssisting?"

"Well — I asked him to —if it was going to be next week. I just— I wasn't sure what would come of _my_ situation and —"

"What am I _always_ saying, Elsie. You've got that man wrapped round your little finger. . ."

"I do_ not_!"

"Scrubbing in on your _cases_, brings you _coffee_. You've got him well trained." Beryl teased.

"I'll be in pre-op." Elsie grumbled, throwing her a look. "Page me if it's urgent."

"Don't I always?"

Moving through the hospitals halls, Elsie could feel the energy beginning to buzz all around her. The gala put everyone in a brighter mood, but she worried that their mirth would compromise their focus. Still, as she made her way to pre-op, when the young nurses smiled at her, she smiled back.

Coming around the corner she heard Dr. Carson before she even had a chance to ask which bed her patient was in. Following the low rumble of his voice, she hovered outside the curtained area only briefly, before nudging her way through it.

"Dr. Hughes," he said, slightly startled. "Good morning."

"Good morning, Dr. Carson" she said vaguely. She turned to Stephanie who gave her a long, uncertain glance. "Stephanie — _so_, they've moved your surgery up. That's good news."

"I mean — I _guess_?" Stephanie said, "I'm kind of nervous because isn't this Dr. Swire kind of . . ._new_?"

"New to _us_," Dr. Carson corrected, "Not new to surgery."

"She's like _twelve_," Stephanie whispered. Dr. Carson mumbled, busying himself with her chart. Elsie lowered her face slightly to conceal the tiniest of grins.

"Well, Dr. Carson is assisting so you've no reason to be concerned."

Stephanie gave her another look and Elsie moved closer, sitting on the end of the girl's bed.

"Yeah— but he's like twelve _times twelve._"

"It's going to be fine," Elsie said, patting the girl's hand reassuringly. Before she could continue the curtain pulled back with a swoosh and they all looked up to see who had come in.

"I know _you_ can't have anything but I needed coffee," Samantha looked up, noticing that apparently the number of people in the room had increased since she'd left. She looked sheepishly at Elsie. "Good morning, Dr. Hughes."

"Good morning, Samantha." she said, studying the girl's pale face.

"You're killing me Sam, I'm _so effing thirsty._"

"Sorry," Sam said, forcing a smile through her obvious fatigue. "I've got to make sure I don't take a day- long nap and miss when you wake up."

"I need you to be there to ask me who the president is and what year it is and stuff," Stephanie laughed.

"Dr. Bates is on his way in to administered her sedation," a nurse said, peeking between the slit in the curtain. Elsie could see that she'd recently had an eyebrow wax; pre-gala primping had clearly already begun.

"Thank you," Dr. Carson said. "With that, I'll take my leave to go get scrubbed in. Stephanie, I shall see you on the other side."

"_Sans tumor_?" she asked.

"Sans tumor." he said. He paused, giving Elsie a peculiar look, then disappeared behind the blue and white curtain just as John came in.

"Hello," he said, "I'm Dr. Bates —and I have all the good drugs."

Stephanie snorted, "Do they call you _Dr. Feelgood_?"

John laughed, uncapping Stephanie's IV, "You know, they _don't,_ but they _should._" he looked at Dr. Hughes, "Perhaps you can arrange that."

"I'll get _right_ on it."

"Alright, you won't feel anything for a few seconds here — then you'll just begin to feel very relaxed, maybe a little silly," John said.

"Dr. Hughes if you're her doctor why aren't _you _scrubbing in?" Samantha said meekly, wrapping her hands tighter around her coffee cup.

Elsie swallowed, "Well, Dr. Carson is a surgeon, that's his specialty."

"There you are, Stephanie. So, they'll come fetch you in just a minute and I'll see you in the OR." John said, nodding to Elsie as he gathered up his syringes and headed back through the curtain.

"Wouldn't you want to at least see what's going on?" Samantha said quietly, one eye watchful on her friend, who had begun to stare somewhat intently at her hands.

"Dr. Carson is, quite simply, the _best_ surgeon here. I feel more comfortable putting my patients in his hands in the OR than my _own._ I trust him implicitly."

"Cuz he's your _boyyyyfriend_?" Stephanie slurred, struggling to keep her eyes open.

"Is she stoned?" Samantha asked, putting her hand protectively on Stephanie's arm. "Steph, I'll be here when you wake up, I _promise_. Don't worry, it's all going to be okay."

"I don't even . . .have any _fucks_," she said slowly, a small laugh bubbling up as she let her head fall back against the pillows.

"She's not going to remember _any_ of this is she?" Samantha said, looking up at Elsie.

"Probably not," Elsie laughed. Then she noticed the girl's face tensing, her nervousness not allayed by her friend's somewhat humorous degree of sedation.

"I know I've only known her, like, a _week _but we're already such good friends, and I just don't want anything to happen to her. Like, I don't want her to die or wake up and be someone else — I just," she let out a shuddered breath, "Dr. Hughes, I kind of need her and I think she needs me too. And you must have known that because why else would you have introduced us?"

Elsie smiled softly, putting a hand on the girl's shoulder. "She'll be okay, poppet. But you need to worry a bit more after _yourself._ She'll be in surgery most of the day, so why don't you go have a lie down. Save your strength."

Samantha looked a moment longer at Stephanie and then nodded, reluctantly. "Is Dr. Carson really the best?"

"He really is," Elsie said, "In fact, I have to have a procedure next week myself. And I'm going to ask him to perform it."

Samantha's eyes widened, "Well, I guess that's a pretty good endorsement. Are you scared?"

Elsie paused, pushing open the door to the hall so that they could head back to pediatrics, "No," she said simply, realizing it for the first time herself, "I'm not."

* * *

"Has the lumbar shunt been placed?" Dr. Swire said, breezing passed Charles as the scrub nurse helped her into her gloves.

"Who's she asking?" John said, turning to Charles.

"Good morning Dr. Swire," Charles said, "The shunt has been placed and she's been started on mannitol."

"Pleasure to see you again, Dr. Carson." Dr. Swire said, brusquely, opening her hand to one of the circulation nurses. "I'll be proceeding with a frontotemporal craniotomy. We'll drain the cyst portion of the astrocytoma and remove the solid tumor directly after. Dr. Carson, if you'd prep the drill, please."

Moving her hand expertly over the exposed scalp, Dr. Swire made her first incision, deftly lifting and separating the thin layer of skin and muscle. As the bone of the skull came into view, she flexed her fingers.

"I'll drill the burr hole here," she said, pressing her gloved finger against the side of Stephanie's skull. Flicking her gaze up at Dr. Carson, she waited for confirmation. "You'll assist with the craniotome?"

"Yes," Charles said — a bit taken aback by Dr. Swire's eerily calm demeanor. "And once you've exposed the dura?"

The drill whirred to life and his question went unanswered. Not that it matter, it had been wholly rhetorical. He was just a bit unnerved by her swift approach.

"Retractors," Dr. Swire said, passing the drill to one of the awaiting nurses. She adjusted her loupes and dropped them down over her eyes, preparing to observe the fine veins of the brain.

"Have you performed many craniotomies, Dr. Swire?" Charles said, steadying his hand against the retractor, feeling the tension fighting back from the skull.

Without looking up from her work, Dr. Swire chuckled, "Well — I've done more than _you_ have, Dr. Carson."

* * *

"Of course I'm on call, aren't I _every_ year?" Mary said, dropping her coat and bag in one of plush armchairs in her father's office. "I only go to these things because I know how disappointed you'd be if I_ didn't._"

"It's important night for the hospital _and_ for the Crawleys. I prefer it when we're all together."

"Dad,_ every_ day is a family reunion walking these halls. We've really exceeded the number of acceptable Dr. Crawleys. I don't even think they call Edith that anymore."

"They don't, actually." Robert said, laughing slightly. "I mean, I suppose it's not really_ that_ funny but—"

"Is gram giving her yearly speech?"

"Of course,"

"Oh _goodie,_" she said, crossing her legs.

"I've been meaning to ask you, do you recall Dr. Swire from uni? She seems quite chummy with Matthew."

Mary blinked, "So I've noticed. I can't say that I have any recollection of her, no."

"What's your first impression?"

"Well," Mary said, pursing her lips and settling her hands against her knee, "She's not lost a patient yet."

"Wow, what a _rave _review." Robert chuckled. His phone buzzed loudly on his desk and he glanced at it then picked it up, "It's your mother."

"I've got to go anyway. 6 o'clock tonight?"

Robert nodded, giving her a wave as he answered it. "Hello, darling," he listened a moment, then pinched the bridge of his nose between his thumb and forefinger, "No, darling, I don't know whether or not they'll have those puff pastries this year. But if they _don't,_ I'll buy you some at the patisserie this weekend, how's that sound?"

* * *

"I don't feel like I've _been_ here long enough," Daisy said, twisting the end of her ponytail around her finger. "It's like — I don't have anyone to _go_ with, it'd be like going to prom all alone."

Anna looked up from the banana she was hastily peeling between rounds, "_I'll_ be there, and Beryl, and lots of young nurses from other units you've not met yet. It's a great networking opportunity,"

"I don't think I have any dresses nice enough," Daisy said quietly, "I don't want to look out of place."

Anna studied her a moment, nibbling the banana, "Daisy, what time is your shift over?"

"Well, I can leave at half past three but I'm on call tonight — figured I should volunteer because I can't imagine everyone's clamoring to miss out."

Anna smiled, "Thoughtful of you! Well, I'm off at 3, so I'll wait and you can come back to my flat. We can get ready together. I've a dress you can wear — and you'll look spectacular in it."

"Oh, _Anna_!" Daisy said, her face brightening, "That's so nice of you — but you really don't—"

"I _want_ to! I haven't any girlfriends to help me lace up mine and I'll definitely need some help getting my hair curled. I can _never_ get the back myself with the rollers."

Daisy laughed, "Me neither."

"Good — it's settled then." Anna said, popping the last bite of banana into her mouth and tossing the peel in the bin. "It's going to be a brilliant night." she said, wrinkling her nose and giving Daisy a quick wink, "We always have _loads_ of fun."

* * *

"It's your day off, darling, why are you awake?" Rosamund said, clicking on the speakerphone in her office so that she could pull apart the muffin she was working on with _both _hands.

"Well, I just wanted to check in." Edith said, and Rosamund could hear her rolling over in bed.

"If you weren't my niece I'd say you're _dedicated,_ but I know you better." Rosamund sighed, "You're _neurotic_, just like your poor mother."

"I just — I worry about my patients."

"Yes, and you need to _stop doing that_. When you go home,_ you go home. _You can't take them with you. Physically, mentally, spiritually. . ."

"I know," Edith said quietly, "I'm trying not to."

"Well, try harder." Rosamund said, "Anyway, since you called – did you decide between those two dresses or are you going to leave it until the last possible moment?"

"I like the green one,"

Rosamund hummed pleasurably, trying not to spit muffin crumbs all over her desk. "Oh! I'm _so_ glad, that one was my favorite."

"I don't think I have the right shoes, though."

"You'll have them off in the first hour, you know that."

She could almost hear Edith smile, "That is how it usually pans out, isn't it?"

"Yes, my _tiny dancer._" Rosamund cooed, "That's one thing you've got the upper hand on."

"Only 'cause Mary stopped taking classes when we were teenagers. If she'd kept up she would have been better than me. Just like she is at everything else."

"I _respectfully disagree_. Mary could learn the steps but _you_ have rhythm."

"Well, at least since I'm on call I won't drink and make a fool of myself."

Rosamund laughed, "Good — because _I'm _not on call, _I will_ be drinking and _no doubt_ will be making a fool of myself."

* * *

"So, will I see you this evening Isobel?"

Isobel turned from the shelf she was restocking, "Oh – good morning." she smiled, "I'm still not entirely sure. Matthew's taking Lavinia. Their first gala at Downton, I suppose I should attend if only to watch them enjoy themselves."

"Don't you think you might enjoy yourself as well?"

Isobel laughed quietly, "I'm not one for drinking _or_ dancing, Dr. Clarkson. And I've given my heart and soul to Downton — but am in no position to give them anymore of _my paycheck_ than I already do."

"I'm with you there," he said, "Well, if you think you'd like to go, perhaps we can sit together."

She cocked her head slightly, her eyes sparkling. "Only _sit_?"

"Well, perhaps a dance. I don't think I dance but—"

"You don't _think _you dance?"

"I'm not ruling it out, merely making sure your expectations remain low."

"Oh _my_," Isobel said, clapping her hands together, "I think perhaps now I _have_ to go."

* * *

Having just woken up from a much needed midday nap, Cora stepped blearily into the kitchen and saw Sybil standing at the stove in four inch heels. She wondered if she was still dreaming.

"Darling, _what_ are you doing?" she said, rubbing sleep from her eyes. Sybil turned to look over her shoulder at her mother, the rollers in her hair bobbing against her face.

"Making grilled cheese,"

"Let me do it, you'll get it all over your dress." Cora said, padding across the kitchen. "We're leaving in an hour, don't you want to just wait until we get there?"

"Um, _no, _because the food is weird there and I'm hungry _now._"

Cora nudged her daughter aside with her hip and took the spatula from her, "I really love that dress. The shoes a little intimidating though,"

Sybil teetered over to the kitchen table and sat down, reaching up to begin untangling the hot rollers from her long tresses. "It doesn't matter I'm just gonna take 'em off anyway, right?"

"How tall do you think Tom Branson is?" Cora said, pressing the spatula into the sizzling grilled cheese.

"Mum," Sybil warned, "He's_ just_ a friend. Basically my _only_ friend."

"He seems like a very nice young man," Cora said, turning the stove off with a click, "I don't know a lot about him before he came to Downton. He's Irish, right?"

"_So much_," Sybil breathed, concealing a squeal. "He _is _really nice, mum. We have a lot of laughs together and he just — I don't know, he really _gets_ me. Like, he doesn't want me to be anyone but myself and it's just so easy to be around him."

Plating the grilled cheese, Cora paused, "Sybil have _I _put too much pressure on you about school?"

"Woah — _segue alert_." Sybil said, watching her mother slowly cross the kitchen to join her at the table. Although she was ravenous, when Cora slid the grilled cheese toward her, she hesitated.

"I'm glad that you can be yourself around Tom, I think that's wonderful," Cora said, "But I hope that you know that _we_ love you for who you are, too."

Sybil blinked, then slowly lowered her gaze. "I mean — _you _do, mum. I've always felt like you see who I am and love me anyway. But I'll be honest. I think dad only sees the daughter he _wants_. I mean Mary's who he wants us _all_ to be. Edith tries and . . .I don't know, he just kind of overlooks her. Maybe she's the lucky one, I don't know. Grams the same way, she doesn't see _me, _she just sees all the ways I'm not like Mary."

Cora felt her chest tighten, "I think they just believe that they know what would make you the happy."

"But they _don'_t, mum. They've never even _asked._ They just assume that what makes _them_ happy will make _me_ happy." tearing off a corner of her sandwich, the cheese sticking to her fingers, she sighed, "Doesn't dad kind of do it to you too? I mean did you _really_ want to just sit here and raise kids while he went off and had this amazing career?"

She was certain Sybil had meant to sting her, but suddenly Cora's entire body felt pricked. She hoped she hadn't visibly winced. "All I wanted was for everyone to be healthy and happy and I think we mostly have been," Cora said levelly, "I didn't have the same aspirations your father did. I've never wanted a career in medicine."

"Yeah but didn't you want a career in _something_?"

Cora thought a moment, then reached across the table to tear off an edge of Sybil's sandwich. "I liked art history. I have a bachelor's in it."

"Wait —_ really_?" Sybil said, "How come I never knew this?"

Cora shrugged, "I don't know, I guess it doesn't matter really."

"Mum, _yes it does_. You like art and history and," Sybil paused, her mouth half open, "I feel like I don't even know you. W_oah._ This is so weird. What else are you hiding from me?"

Cora smirked, "Nothing, I'm afraid. I'm terribly uninteresting."

"What was your thesis on?"

"Piero della Francesca, early Renaissance art."

"You could have been like that guy on that show we used to watch — you know, he got into lots of trouble and went to auctions and had that super posh lady friend?"

Cora smirked, "_Lovejoy?_ You remember watching that with us?"

"Yeah, you freaking_ loved_ that show. Now I totally get _why._" Sybil said, popping another corner of grilled cheese into her mouth. "You could have been the chick, too."

"Lady Jane? Hardly. Actually, did you know that the actress her played her isn't even English? She's_ Scottish._ The posh accent was totally put on."

"No way! It was hella tight." Sybil swallowed, then looked at her mother straight on, "Mum, seriously though, just think about it. Your life doesn't have to be over. You could still use that degree. They don't have an expiry date."

"Maybe," Cora sighed, "I thought I might try to do something once you girls were grown and gone but," she pet her belly gently, "My plans have changed."

Sybil glanced up at the clock behind them, "Mum, _shit_, we've only got like a half hour until the car comes. You've got to get dressed."

The chair squeaked across the floor as she pushed it back, leaping up and reaching for Cora's hand.

"Oh, _do I have to_?" Cora said.

"Yes, you do." Sybil laughed, dragging her out of the kitchen, "You know dad is going to do something totally asinine once he has a few drinks in him and you need to be there to save face."

"If that's the case I think I'm already _living_ in an episode of _Lovejoy._" Cora laughed, kissing Sybil's cheek.

* * *

Edith grabbed her handbag when she heard the town car pull up out front. She'd been waiting by the front door, knowing if she didn't zip right out Rosamund would make the poor driver honk indignantly. He exited the car and opened the door for her as she made her way somewhat self-consciously down the front stoop. She was wearing a new pair of heels that she'd not yet broken in and they were already blistering her toes. Sliding into the car, she thanked the driver as he shut the door.

"You look gorgeous, honey." Rosamund said, a glass of champagne already in hand. Edith smiled, recognizing her aunt's annual practice of _pre-gaming. "It gives me a nice rosy flush when I walk in,"_ she always said, but Edith knew she just needed to loosen her nerves so she didn't strangle anyone.

Rosamund hadn't always been so rough around the edges, but after her husband died, and the aftermath of the affair with Tony's father, she'd become the black sheep of the family; something Edith understood completely. She was probably the only person who became _closer _to Rosamund after her life fell apart, sullying the family name in the process.

"So, you remember the plan?" Rosamund asked.

"Um — I _guess._ I'm just supposed to keep an eye on Mary so that Tony doesn't, I don't know, _ruin her_?"

"Essentially, yes — though do try to muster up a bit more enthusiasm, darling. A sense of adventure."

"I just want to dance, though." Edith pouted, laughing slightly. "You _do_ realize that Mary would never do the same for me. She'd never look out for _me_."

Rosamund rested her hand on Edith's knee, "Yes, I know — because _you_ are a such a sweet girl, the nicest little chicken in the Crawley clan and _darling_ — Mary is so lucky to have you." she lifted the champagne flute to her lips, "Don't tell the others — but you're my favorite."

* * *

For the second year in a row, Mary put the finishing touches on her makeup in the locker room outside the surgical suite. She felt a little ridiculous knowing that she'd have to stride through at least a few of the main halls in her gown en route to the ballroom, but there was also a slight thrill attached to it. She looked stunning _and she knew it._ Maybe it would help to bolster her commanding presence. Patting down a few stray hairs, she took a couple of steps back, trying to see as much of herself in the skinny full-length mirror on the side of the lockers as she could.

"Well, _you_ clean up nicely Crawley."

She turned, startled. Matthew was leaning up against the set of lockers closest to the door. He was already fully dressed as well, black tie, hair slicked back. Mary felt her heartbeat quicken and silently cursed it.

"I could say the same of you, _other Crawley_." she said, leaning down to grab her clutch and phone from the bench in front of her. "Where is Dr. Swire?"

Matthew nodded toward the door, "She's dressed but — well, she had to finish charting."

Mary smirked, "I think I'll hurry and have a look. Not everyday you get to see a surgeon dictating in _sequins._"

Matthew lowered his gaze, concealing his smile.

"I, uh, wasn't sure if you'd had a chance to properly meet her. Maybe we can all have a drink together tonight. Get to know one another better."

"I'm on call, Dr. Crawley." Mary said, straightening her spine, "And if you'll pardon me, I was just on my way out."

"Well, if you wait just a minute we could all walk over together," Matthew said, turning as she breezed past him.

"Sorry," Mary said, lifting her chin, "I don't _wait_."

* * *

Charles checked his watch again, then glanced out the window to look at the front door of Dr. Hughes' flat. He was precisely on time, had actually been a few minutes early. He'd just sent her a text to let her know he'd arrived, but _not to hurry_ that they had _plenty of time_, but he was eagerly awaiting her presence. When he saw the door open, he heard the chauffeur move to open the door.

"No, no, allow me." Charles said, pushing his door open. When he stepped out of the car onto the sidewalk, he lifted his head just as Dr. Hughes' began to descend the steps.

She had her hair down, slightly curled, it's auburn hues glistening in the light of dusk. As she glided down the front stairs, she lifted her dress, royal blue floor length with a cinched waist and a plunging neckline. She smiled, giving him a small wave.

"Well, here we are." she said, giving a small shrug of her shoulders.

He swallowed hard, _she hasn't the slightest idea how beautiful she looks. _

"Please, after you." he said, a bit forcefully, stepping aside as he pulled the door open for her. Once she had settled in, he joined her, feeling the satin of her dress against his hand.

"You look, very nice, Dr. Hughes." he tried, his mouth suddenly incredibly dry.

"As do you, Dr. Carson." she said, reaching up to fiddle with one of her dangling earrings. "This ought to be a fun night."

"Oh yes," Charles said, glancing around for the bottle of champagne he'd seen earlier. Anything to quench his sudden thirst.

"Are you alright?" Dr. Hughes asked, "You look flushed."

"Nothing serious," he said, locating the bottle, "I just — I'm something of a back-seat driver, I'm afraid. Always bothered when I'm not in the driver's seat."

Elsie laughed, "It's only a few more blocks." she said, patting his knee reassuringly.

He stiffened against her touch, the bottle cool against his hot palm.

A few blocks of_ eternity._

* * *

"I can _never_ die," Violet said, folding her arms across her chest. "These galas would implode without me."

Isobel smirked, shaking her head. "I can't disagree," she said, "But if you despise them so much why do you insist on throwing one every year?"

Violet looked at her incredulously, "Well, the _endowment_ for one, Isobel. Plus it's just a matter of tradition. People expect this. It's the social event of the year."

"Oh, well, _of course_." she rolled her eyes slightly, "You've got it down to a science now. So long as you leave instructions I'm sure it will carry on and thrive in your eventual absence."

Violet huffed, "Well, I don't plan on dying any time soon, _dear. _Much as it pains you."

Isobel laughed, elbowing Violet slightly. "You know I'm only teasing."

"Yes. Like my personal court jester."

Looking up just as Robert, Cora and the girls came into the ballroom, Violet clapped her hands excitedly.

"The girls are so grown up!" Isobel said, "Look at _Sybil_."

Violet did, her face twitching a bit. "Indeed. _Look_ at Sybil."

"Hi gram!" Sybil said, the first to come to Violet since she'd not seen her since the term started.

"Hello darling," Violet said, embracing her. "Is this the newest fashion from London? Dressing like a _streetwalker_?"

"_Mom_," Robert grumbled, "Couldn't you just say _hi, how are you_ like a normal person?"

"I needed to be sure this was, in fact, my granddaughter and not some _hired escort_ of yours."

Sybil held her breath, then turned to Cora, "I'll be . . .at the bar." and took off across the dance floor.

"Hello, gram." Mary said, taking Violet into a delicate hug. "The room looks marvelous as always. Terrific job with the catering."

"Thank you, dear. Yes, I think we've really outdone ourselves." She looked over Mary's shoulder at Cora, letting her gaze fall onto her belly. "Cora. You're looking _well._"

Apprehensively, Cora stepped forward, allowing Violet to stiffly kiss her cheek. "I am well, thank you." she said, blinking slowly to Robert, hoping he had reminded Violet that they had yet to announce her pregnancy.

"Mama, you look beautiful." Robert said, kissing Violet's cheek and taking her hand. "Well done on all accounts. Downton would surely sink without you."

"Hello, gram." Edith said quietly, giving a small wave.

"Oh, Edith. I didn't see you!" Violet laughed, "Where's Rosamund?"

"She's, um—" Edith said, nodding to the bar where Sybil and her aunt took a simultaneous shot.

"Passing down a tradition, I see." Violet said, turning to Isobel, "It's going to be a _long_ night."

* * *

"Where'd you get that little number?" Beryl said, turning from her spot at the bar to greet Elsie, who was making her way toward it.

"Oh, it's been in the back of my closet for years," Elsie said.

"Not _your_ closet. Maybe _Chanel's_ closet." Beryl smirked, patting the seat next to her. Elsie hesitated, looking over her shoulder.

"Dr. Carson's at the coat check," she said by way of explanation. Beryl raised an eyebrow.

"Oh yeah? With _your_ coat?"

"Well, _our_ coats." Elsie said, blushing slightly. "We just figured we'd come in the same town car. We only live a few blocks apart and—"

"Did he ask you to come _with_ him?"

"Not like _that_, it just made sense."

"Sit your ass down!" Beryl shrieked. Elsie obliged, noticing for the first time how crowded the ballroom already was. Even as close as they were sitting at the bar, she still had to raise her voice to be heard.

"Has he ever actually_ been_ to one of theses shindigs?" Beryl said, pushing her already emptied glass toward the bartender.

"Not that I recall." Elsie said, turning to watch him cross the ballroom, stopping to shake the hands of a few colleagues. He looked very smart in his suit. His hair was even tidier than usual, it's silver darker in the room's moody lighting.

"You're a_ siren_, Elsie Hughes." Beryl said, nodding to the bartender as he poured her another whiskey.

"Oh, Beryl." Elsie chided.

"You've got him hook, line and sinker. Now whatever you do, _don't_ fuck it up tonight."

Elsie turned to throw her a look just as she downed her drink, smiling against the edge of the glass. When she turned back, Dr. Carson was standing next to her, hovering a bit awkwardly.

"Have a drink, Dr. Carson!" Beryl said, "What's your poison?"

Charles sat down slowly, careful not to brush his leg against Elsie's dress again. He looked somewhat sheepishly at the bartender, "I'll have a Manhattan, please."

"And for the lady?" the bartender said, eyeing Elsie.

"A . . .um, _suffering bastard_."

Beryl laughed loudly and suddenly, sputtering her whiskey. Elsie flushed.

"You like _bourbon_?" Charles asked, unable to conceal his surprise.

Elsie didn't meet his gaze, instead, busied herself looking for something in her handbag. "Um, I do. Occasionally."

"Say _bastard_ again!" Beryl laughed. Charles pressed his lips together to keep from smiling. He didn't want to humiliate her but she had requested her drink with a certain adorability that had clearly entertained even her closet friend.

The bartender slid both of their drinks across the bar and Elsie nodded, immediately taking a rather large sip. Charles slowly reached for his, admiring it a moment before having a taste.

The music pounded around them, an eclectic mix of tunes that would hopefully satisfy a rather large generational gap. Beryl swiveled around to look out at the dance floor, waving animatedly to Daisy and Anna who were eagerly trying to get her to join them.

"I think I'm being summoned for some _booty-shaking_," Beryl said, downing the last of her drink, "And I'm _just_ drunk enough to do it. Catch you later," she leaned over to Elsie, _"Don't. Fuck. It. Up."_

Elsie buried her lips against her drink and watched Beryl teeter across the dance floor to the sounds of Anna and Daisy's delighted squeals. Some impetuous pop song echoed in the speakers, nothing Elsie knew since she hardly ever listened to anything on the radio aside from the BBC. She glanced over at Dr. Carson who was nursing his drink, his brow deeply furrowed.

"What — what is this song even_ saying_?" he said, his eyes closing momentarily as he attempted to discern the lyrics. Elsie quieted, listening as the chorus returned.

"Um —I think she's saying — something about going down, yelling_ timber_ — perhaps like when you are cutting down a tree? You know, you yell _timber_?"

Charles shook his head, "If she's falling over she probably needs _medical attentio_n. Orthostatic hypotension or the like."

Elsie smirked, setting her drink down. She turned to watch the girls dancing with Beryl and let her eyes stray around the room. The gala was the only time of year she really had a chance to get a good look at all the new interns and doctors. With each year that passed she found she recognized fewer faces, and the faces she _did_ recognize were aging at an alarming rate. Her eyes happened along a few of the Crawley girls, all of whom were perpetually young in her mind's eye, but here they were in the flesh, full grown women.

"Oh, _look_—" Elsie said, leaning in to whisper to him as he finished off his drink, "Edith Crawley's_ quite_ the little dancer. Who'd've thought, quiet slip of a thing that she is."

"Well, _all_ the Crawley girls took dance classes as children." Charles said, wiping the drips of water from the bar left by his glass, "Ballet, if I recall. I attended a few recitals in Robert's place— duty calls and all that."

"That was nice of you," Elsie said.

"Well, Edith was the only one who kept up with it. Sybil hated it from the start— because ballet is all about rules and order. Mary liked it well enough but she didn't possess — well, what you'd call _rhythm_, I suppose. She couldn't stop _thinking_ long enough."

"I can see that."

"Edith though — well, she danced right through college. I suppose once she entered medical school she had to give it up."

"As one must when they devote their lives to medicine."

Charles sighed, watching the young doctors loosen up. Edith had come alive, moving effortlessly and almost uninhibitedly around the floor. Anna and Daisy had joined her, and the girls smiled, laughing and clapping. Even Beryl was getting into the _insipid_ groove.

"Anna's got the right idea," Charles laughed, nodding toward them, "She's taken her shoes off."

"Look at them go — how do they have so much_ energy_?" Elsie marveled, resting her chin on her hand.

"Boundless youth," Charles said, "I'm going to have another drink — would you like something?"

Elsie sighed, "I _shouldn't_, but—" she bit her lip, looking up at him aglow.

"Go on, it's the _gala! _How about something a little brighter spirited than a _suffering bastard_?"

He smiled, his eyebrows waggling at her. She let her gaze linger on his a moment before downing the last of her drink and pushing the empty glass toward him.

"Yes, your right. _No more bastards_." she said, pulling her bottom lip under her front teeth in a naughty grin.

Charles lifted his hand to catch the bartender's attention, a smile spreading across his lips, "Words to live by, Dr. Hughes."

* * *

"I always enjoy the implied _optimism_ of choosing this song for us," Cora said. Robert held her close, dancing to _Wonderful Tonight _just the same as they had every year since they'd been attending the gala.

"You_ always_ look wonderful, darling." he said, pressing his cheek to hers. "It's not optimism, just years of evidence."

"You're sweet," she said, "I hope you still feel the same in, oh, about _four months_."

"Even more so, I will."

Pulling her a bit closer, they moved effortlessly around the floor, the way that people move through physical space and time when they've been married for so long.

"Do you remember that show we used to watch, _Lovejoy_?"

Robert laughed, "Whatever made you think of _that_?"

Cora let her eyes flutter closed, trusting Robert to lead her. "I was thinking about art, about architecture. This ballroom is beautiful but it could use some renovation."

Robert turned his face slightly to kiss her cheek. "If it's ever in the budget you'd be my first consultant."

Cora sighed. It would_ never_ be in the budget.

But at least she'd tried.

* * *

"What — what is he even _saying_? He's bringing sexy _back_?" Charles laughed, "Well, where did it go?"

Elsie smirked, nursing her drink. "I think poor Joe Molesley's_ commandeered_ it," she said nodding toward the wilding gyrating nurse.

"Perhaps someone should cut him off."

"Oh, he's not been drinking. He's on call tonight." Elsie laughed. "He's just been _moved by the spirit within_, I think."

Having left the bar and made their way to a corner table, they had spent the better part of the evening in pleasant camaraderie. She'd venture they were even approaching something like_ fun,_ watching their colleagues interact, scouting out all the new, young doctors who were practicing medicine in a world nothing like the one they had learned in.

"Who is this fellow who keeps approaching Mary?" Charles said sternly, "I've not seen him before."

Elsie squinted overtop her glass, "I'm not sure. He's got a friend with him — that one, there, with the Armani suit."

"How can you tell that?"

Elsie snorted, "How can you _not_?"

"Well, I don't like the looks of either of them. Why are they even here? Are they doctors?"

"Doubt it, not with those suits." Elsie said, "I bet they're pharma reps."

Charles snapped, "Yes,_ very_ well spotted Dr. Hughes. Good God, they don't give it a rest, do they? Oh — look, look he's getting her to dance!"

"How terribly romantic," Elsie said, "_Care for a dance, love? While we're at it let me tell you all about our new prescription for erectile dysfunction_."

Charles laughed into his drink, reaching up quickly to dab the droplets from his chin. He looked over at her and smiled. She wore a cheeky grin and her eyes were sparkling even brighter. The music changed again and Charles winced immediately.

"This one sounds like — a buzzing monitor on the fritz." Charles said, "I can't even understand what they're saying."

"Everyone seems to know it, look"— Elsie said, nodding to the dance floor. Even Robert and Cora were swinging together, singing the refrain.

"Well, _young folk_ — you know, hep to the jive and all that. . ."

"It's _boppy_. Has a good beat to _bop_ to."

"I suppose, if you enjoy. . ._bopping_."

Elsie stood, reaching for her glass. "I'm going to _bop_ my way over to the bar. Maybe you'd care to join me?"

He blinked.

"If dancing happens along the way,_ so be it_ —" she said, turning to leave it up to him to join her. He watched her sway away from him a moment, then pushed his chair back and doubled his steps to reach her.

"Okay, fine." he said, "_Bop away_."

Pleased, and a little flush from the alcohol, she smiled, watching as the dance floor alighted with the bouncing and hopping of their excitable, slightly drunk colleagues.

_Let this be our little secret, no one needs to need we're feeling_

_higher, higher, higher, higher. _

Elsie set her empty glass down at the bar and turned back to him. "C'mon, we might as well. Even _Beryl's_ into it." she said, pointing to the nurse, who was right in the middle of Daisy, Anna and Phyllis — all of whom were cheering her on as her fist pumped the air excitedly.

_Oh, have you ever felt so goddamn strong?_

_How come it takes some people so damn long? _

"I have no idea how to dance to the sound of . . .I don't know, _dial-up modems_ or whatever it is."

Reaching out to take his hand, Elsie pulled him away from the bar. "You just. . _.feel_ it."

He felt a flush start where their hands were touching, traveling the length of his arm all the way up to his chest, neck — and then, he supposed, his face. Luckily the room was warm, so he only looked a bit overheated.

Elsie began to happily bop straight away, her sense of rhythm apparently deeply ingrained, but well hidden. He'd never had envisioned her having any_ musicality_, really. Noticing his hesitation, she reached out for his other hand and pulled him closer, wrapping one arm around his waist and taking the other so that she could lead them.

"You can't waltz to it, but —" she laughed, scrunching her nose at him encouragingly.

"I'll follow your lead," he managed, the feeling of her pelvis moving against his making his breath hitch.

Around them the room came alive singing the refrain, _higher, higher, higher — _and Elsie threw her head back, letting her arms rise up in triumph along with everyone else.

"Shake it, Els!" Beryl said, hobbling toward them as she attempted to kick off her shoes.

"Shake _what_?" Elsie called back.

"I don't have to tell you," Beryl laughed, "You got Charles Carson to the gala and on the dance floor, clearly you've got it goin' on in more ways than one!"

Elsie was glad she was still looking over his shoulder, so he couldn't see the way her lips parted in a wide smile, one that she couldn't have swallowed back if she'd tried. She calmed her expression and pulled back, holding his hands in hers and encouraging his awkward bopping.

"I feel ridiculous," he said, his voice lost in the fray.

"Well, _good._" she called back, leaning in closer to be certain he'd hear her, "We're getting on you and I. We deserve to live a little."

The song ran through a final chorus and they stopped, breathless and clapping. She dropped his hands and he felt suddenly lonely without them. She turned and gestured to their table, but the microphone on the stage came to life with a dull click and everyone turned.

Violet Crawley had taken the stage.

"Oh, _fuck_." Beryl said, "I'm not yet drunk enough for this."

Elsie laughed, swatting Beryl's arm, "_Hush up_."

"Dear colleagues, friends of Downton and family — thank you so much for joining us tonight." Violet began. Elsie felt someone tap her shoulder and she turned to see Anna, somewhat breathless, standing behind her.

"Dr. Hughes, I'm sorry," she whispered, "Daisy's on call for pedes but they've paged . . ."

Elsie's face fell. She didn't want to admit to the nurse just how much she'd had to drink.

"Anna, have you had anything to drink yet this evening?" Dr. Carson whispered.

"No, Dr. Carson. I don't drink." Anna said. She turned back to Elsie, suddenly understanding what she didn't want to admit. "I forgot you're not on call this year," Anna said apologetically.

"Would you mind going instead?" Elsie said, "I know you aren't on call, but she's_ very_ new and—"

"I don't mind," Anna said, "_Really,_ I don't. But will you just let John know that I've run out? He's gone to the loo and I can't wait for him to come back. But I don't want him to think I've left him to go stag the rest of the night."

Dr. Carson chuckled, "We'll let him know."

"Thank you, Anna." Elsie said, taking the girl's hand. "I'll make it up to you."

Anna shrugged, "I need a breather anyway," she said, pressing her hand to her chest. Elsie turned back to the stage, but leaned in to speak to Dr. Carson. "I _do_ feel a bit guilty asking her to go."

"Don't," he said, "You've paid your dues."

Everyone collectively caught their breath listening to Violet's speech and as Anna crossed the ballroom to make her way out to the ward, no one saw her being followed.

* * *

"I _really_ don't think we should be doing this," Tom said, bracing himself on the abandoned stretcher in the dark back hallway Sybil had dragged him into. "I mean, I _want_ to, I _really_ do, but if we get caught out –"

"We _won't_," Sybil said, running her hands along his upper thigh. She pressed her mouth against his hard, both from lust and the desperate need to quiet his concerns.

He pulled away suddenly, pushing her back, "Did you hear that?"

"_Jesus christ_, Tom, _no,_ I didn't hear anything — just the _anguished cries_ of my _vagina_ as continue to reject my sexual advances,"

"Syb, hold on a sec — I hear footsteps."

She stiffened, listening. Sure enough, the distinct sound of highheels was getting louder just to their left. "Oh_ fuck_ — here, get under it."

"Under what?"

"The stretcher _you fuck!_" Sybil said, pulling him down. "It's dark, we're in a corner — just _don't breathe_."

"Okay, okay," Tom said, trying to hold back his laughter as they clamored beneath the stretcher.

* * *

Anna really didn't mind checking in on the unit. It was part of the reason she never drank at these things. She liked being the person who others could count on and, truth be told, she liked having an excuse to leave when it all got to be a bit too much for her. She did like dancing, especially now that she had a few friends at Downton, but having a moment or two to herself helped her stay centered.

She took the back corridor, hoping she'd be able to get to the unit quickly. It hadn't been a code that was paged, but she didn't want to waste any time. It was probably Stephanie, who was still recovering from surgery and when she and Daisy had departed earlier in the afternoon, she'd not yet come out of anesthesia. If she had, she was probably in a lot of pain and no doubt the night nurses were at their wit's end trying to get it under control.

The darkened hallway was eerily quiet, so when she heard footsteps echoing loudly behind her, it was impossible to ignore. She stopped in front of a few abandoned, broken down stretchers, turning slowly.

She couldn't make out the figure in the darkness. But as it moved closer and came into view, she felt the sudden shock of a fist against her face and the sound of clattering metal as her body pitched forward.

* * *

"What the fuck _is_ that?" Sybil whispered, inching forward on her hands so she could peak out into the black hallway.

"I don't know," Tom said, "Did you see who it was?"

"No, but it must have been a woman because those were heels. Maybe she's drunk and she fell."

"Well, we should check on her. Maybe she's hurt." Tom said, but before Sybil could respond, they heard a few thuds and a muffled scream.

"_Oh fuck_," Sybil breathed, pulling herself forward through the underside of the stretcher until she was scrambling into the darkness.

"Sybil wait —_ fuck_ — wait!" Tom said, trying to move through the maze of metal. Sybil stood unsteadily and looked up the hallway, trying to make out what was happening. Outside, an ambulance was backing into one of the bays and the flashing lights came in through the window, briefly illuminating the hallway.

She didn't recognize the man, but the woman on the floor was _definitely_ Anna. The man was on top of her, smashing her head hard against the linolium as she struggled to free herself.

"Get _off_ her you son of a bitch!" Sybil screamed, bolting forward.

"Sybil!" Tom yelled, running after her. He managed to grab her arm but she slipped from his grasp, lunging at the man. Tom paused, trying to mentally triage — Anna was unconscious, blood spattering the floor, which was now illuminated by the silently flashing lights of the ambulance, casting a red glow over the hall. Sybil was on top of Anna's attacker, digging her heels into his calves.

He reached down for Sybil, grabbing her roughly by the shoulders and throwing her off the man. Taking her place atop him, he bunched the man's shirt in his fist and yanked him up, trying to get a proper look at his face. Whoever he was, he didn't recognize him, but it didn't matter, because the shit-eating grin on his face convinced him he was no one he'd ever _want_ to know.

"Sybil, go get help. Anna's hurt." Tom said, "This sick _son of a bitch_ bashed her head into the floor."

"Had to knock her out so I could fuck her," the man spat, "She was gonna fight me." he looked over Tom's shoulder at Sybil, who was now shaking and paralyzed by the realization of what was happening. "Just like this one. Is she yours?"

Before he could think better of it, Tom grabbed the man's jaw and pushed his entire head into the concrete wall next to them.

"Tom, _stop it!_" Sybil cried. As Tom looked up at her, the man saw his chance to escape and kicked Tom's legs out from under him, clamoring up and running off down the hall. Sybil's crying had escalated and she looked down to Anna, the gravity of the situation having fully grasped her. "Oh my god,_ oh my god_, is she dead?"

Trying to get his bearings, Tom pulled himself toward Anna, reaching for her wrist. He waited a moment, then exhaled. "It's faint but she's got a pulse. Sybil." he breathed, wincing as he realized how hard he'd hit the ground a moment ago, "_Go. Get. Help._"

Sybil looked down at him, then at Anna. Tapping into her earlier courage, she leaned down and quickly pulled off her shoes, tossing them aside. She took Tom's face in her hands and kissed him squarely.

Then, she ran.

* * *

"I suppose I've prattled on long enough," Violet said, raising her glass, "So, I will wrap up by thanking you all once again and toasting the ongoing success of this fine institution. For many generations to come, in fact. I hope you'll all join me in congratulating my son Robert and his wife Cora, who are expecting their fourth child. A boy. Hopefully one who will follow in his siblings footsteps and become part of our legendary hospital. To Downton, Precision. Perseverance and Progress!"

Cora's mouth hung open and she felt Robert tense beside her. Before she could reproach him, the crowd erupted in applause, drowning her out. As such, no one heard Sybil's frantic screams coming from down the hall, but as she burst into the ballroom, Cora immediately turned, forgetting all about Violet's indiscretion.

"Sybil!" she screamed, dropping her glass of water, sending it shattering across the floor.

"Anna's hurt — someone attacked her in the hall and — there's blood,_ there's blood."_

"Are you hurt? Where's Tom?" Cora said, pushing the hair from Sybil's eyes.

"Someone help her!" Sybil screamed, but doctors were already setting down their glasses and running past her in a flurry of sequins and silk. She lifted her eyes to who was standing still in the room.

Mary had reached down and taken the hand of the man she'd been dancing with all night. Sybil almost recognized him. Tony, something. And then it clicked.

The man in the hallway had come with _him._

* * *

Tom groaned as the overhead light in the hallway shuddered on above him, but he knew it meant that help was coming.

"Anna, _you're gonna make it._ I promise you. And we'll get that _bastard._"

"Tom! Tom!"

He turned, but his neck was already sore and stiffening by the moment. Dr. Carson lead the charge and a collection of doctors and nurses followed.

"Pulse is faint, but it's there. She's got a massive head injury. Some guy, we didn't know who he was, he grabbed her. I think he was trying to rape her but he didn't get that far. He did bash her head off the floor and — I don't know what else, it was dark but—"

"Are_ you_ alright, Tom?"

"He got a punch in but I'll be alright," he said, struggling to stand. He smelled the faint scent of alcohol on Dr. Carson and paused. "You've all been drinking,"

Dr. Carson paused, "Not _all_ of us."

"_You_ can't treat her." Tom said, turning to look out into the crowd. "Who_ hasn't_ been drinking tonight?" he called, his voice hoarse.

A few hands went up, including Richard Clarkson and Isobel Crawley, who were standing so close to one another their shoulders were touching.

"Dr. Clarkson, stabilize her. I'm going to get the ER night crew to bring a crash cart down and we'll load her up." he said, pushing through the crowd. He felt a hand grab him and turned to see Dr. Hughes staring intently up at him.

"What happened?" she asked quietly, gripping his arm tightly.

"Someone attacked her." he said breathlessly, shaking his head as though he couldn't believe it even though he'd seen it happen.

He moved out of her grasp and took off limping in a half-job toward the emergency department.

She closed her eyes tightly, trying to staunch the tears that were threatening to fall, and when she heard Sybil's terrified sobs in the hallway, she had to cover her face with her hands and turn away.

* * *

"Where is she?!" John hollered, grabbing the first nurse he could find. "Where's Anna Smith?"

"They've _moved_ her," a nurse said calmly, "They stabilized her here but she's been moved to the neuro-intensive care unit."

"Intracranial hemorrhage?" he asked, his voice choked.

The nurse exhaled slowly, hoping to inspire him to do the same. "Just some swelling, and a few broken bones in her face. She's heavily sedated at the moment, but she was _very_ lucky."

At this, he did exhale, his hands coming up to cover his mouth. "What room?"

"455." the nurse said, putting a hand on his forearm. "She doesn't look good, Dr. Bates. She'll make it, she'll _heal_ — but you might want to brace yourself."

* * *

"Sybil, darling, you're okay, _it's going to be okay_." Cora said, stroking her daughter's hair. In the emergency room, which had erupted with chaos when Anna had been brought in, Sybil had been inconsolable for the better part of an hour. Mary and Robert were in the nurses' station, fighting with doctors and police officers, Edith was keeping watch of Rosamund who had taken to idea of drunkenly avenging the attacker and Cora had seen nothing else to do but crawl up onto the gurney and take her little girl in her arms.

Sybil had escaped with little more than a few cuts and bruises, but she was in such a state of emotional shock that they'd had to sedate her. She now was curled limply against Cora in fitful, drug-induced sleep.

Robert appeared in the doorway, his bow tie having come undone at some point, now hanging loosely around his neck. She gave him a harried look. He closed the door softly behind him and came over, sitting on the gurney, resting his hand on her leg.

"How is she?"

"Sleeping at last," she whispered, letting her eyes flutter closed as she inhaled the scent of Sybil's hair, some God-awful mix of shampoo and far too much perfume, but she was so thankful for it.

"How are _you_?" Robert said, reaching up to take her hand.

"Fine," Cora said, slowly opening her eyes. He looked unconvinced. "Really, I'm _fine_ Robert. Exhausted. Angry. Confused."

"I didn't know she was going to make that announcement in her speech, Cora."

"What?"

"About the baby — she just did that on her own. I specifically mentioned that we weren't going to announce it but—"

"Robert," Cora said, a bit too loudly. Sybil stirred uneasily in her arms. "Robert," she said again, quieter, but no less firmly, "I don't care about that."

He blinked uncertainly.

"Robert, _jesus christ,_" she said, her voice a harsh whisper, "Some crazed maniac came into our hospital, into a group of our colleagues, our friends and _our family_ and attacked someone. He might have even _killed her_ in cold blood if Sybil and Tom hadn't overheard." she shook her head, her mouth parted slightly. "Robert I couldn't give _a fuck_ about your mother's complete lack of regard for our privacy, for my life. Not that it would matter if I did!" she huffed, "I am angry, and sad, and confused and _scared _because something terrible has happened at Downton. And considering how much_ you've_ given up, how much _you've_ ignored and pushed aside so that you could throw yourself into this _god damned hospital_, I would think_ you_ would be even _more _upset than I am."

"Cora, I. . ." Robert started, his gaze falling to Sybil. "I'm sorry, I. . ."

"Don't apologize, Robert." Cora sighed, gripping his hand tightly. "Just come here and hold your daughter."

He opened his arms as Sybil slumped against him, curling into his chest immediately. Cora stretched her back and shook out her arms. Robert watched her a moment, saw the gentle curve of her stomach which she had tried so hard to conceal. At this angle, however, with the long skirt of her dress tangled in her legs and pulled taut across her middle, he could see it clear as day.

"I love you," he stuttered, pressing a hand protectively against Sybil's head. Cora looked up, her eyes tired, but grateful. She leaned over, minding Sybil, and kissed him gently.

* * *

It was well after midnight and Elsie had been curled into a chair next to Anna's bed for at least an hour, unmoving. At least she'd managed to take her shoes off before tucking her legs up under the silk of her skirt, which plumed out, engulfing the chair. She'd think it ridiculous if she could think anything at all.

The room was dark, quiet, sterile. As any other intensive care unit would be. The air in the room heavy, though it didn't matter, because the tension that held her together made it nearly impossible for her to take a breath; fearing the sound of her own breathing, the sound of anything other than the steady beat of Anna's heart monitor, the wheeze of the ventilator.

It's life—however little.

She didn't hear him step into the room, but she felt him. In the few hours that had elapsed since they were drinking and laughing and _dancing _something had broken open between them. She felt all the atoms that came together to make him snap and buzz, calling out to her, as he stepped into the room. He sighed behind her and it irritated her senselessly. _Can't he see that they need to be silent? That they need to save their breath? Can't he see that this is all her fault?_

"Dr. Swire said there's too much facial swelling to properly assess her Glasgow score, but she seems to be responsive to pain. She's deeply sedated and shouldn't be in pain now."

He waited for her to respond. When she didn't, he took a step closer to the bed, watching the heart monitor a moment before he continued.

"She doesn't think she'll need surgical intervention but they did place an ICP monitor to keep eye on the swelling. They'll place a shunt if necessary. It would seem that most of the force went to her face rather than the back of her skull."

Elsie winced, glancing up at Anna's face which was completely unrecognizable from the bruising and swelling. Her stomach lurched and she closed her eyes, forcing away a wave of nausea.

"They'll be waking her shortly. To try to assess her again." he said, "She's also on a phenytoin drop but she's had no seizure activity, which is good."

She couldn't stand it anymore, she just wanted him to either_ shut up_ or _leave._ He wasn't telling her anything she didn't already know. She turned to look up at him, but struggled to focus. Between exhaustion and residual alcohol, her head was spinning.

"Nothing about this could be described as _good_, Dr. Carson." she sneered, "This is entirely my fault. I _shouldn't_ have asked her to go. I shouldn't have been _drinking_."

"You're not on call, Dr. Hughes. You've done nothing wrong here," he ventured quietly.

"It doesn't matter; these young nurses and doctors are in _our_ charge, Dr. Carson. They count on us for guidance and — and support and—" she gulped back the sob that was inching up her throat.

She would _not_ cry.

"You couldn't have prevented this. Clearly whoever that man was had her picked from the start of the night. Maybe _before_, even. He saw an opportunity and he took it and thank _God_ for Sybil and Tom. If they'd not intervened it would have been_ so much_ worse. But none of this is _anyone's_ fault except for the bastard who did it."

Hearing him describe the man as a_ bastard_ when just hours earlier they were tittering as the word passed her lips made her realize how quickly everything could change. Surely she'd known that, watched these scenes play out in the lives of patients again and again. In an instant, a car crashes into a semi. In a moment, a child swallows something and chokes. In just a split second, a life could be divided. A deep chasm existing between life _before _and life _after. _

"Why her?" Elsie said, shaking her head, reaching down to take Anna's limp hand.

He sat down at the foot of the bed, facing them both. "There _isn't_ a why, Dr. Hughes."

"There's _always_ a why," she whispered, "And the why is this: _I_ gave that man the opportunity he was waiting for. If she'd stayed in the ballroom, with us, if she'd not gone off alone, if Dr. Bates had been with her—"

"You can't do this to yourself," Charles said firmly.

"But_ I_ did this," Elsie said, her voice strangled by the tears she was trying to squelch.

His hand flew out and gripped her thigh. The force and suddenness of it startled her and she yelped, meeting his gaze and holding it hard.

"Elsie. _No_. Listen to me," he said, staring her down. "You did_ not_ do this. Do not say that— _do not so much as think that—_again."

Her breathe burned her chest and she felt the tears spilling hot onto her cheeks. She wanted to reach up, wipe them away, but she couldn't feel her arms. She couldn't feel anything except for his hand on her thigh and his eyes boring into hers.

The steady bleat of the heart monitor began to swell in her ears, drowning out the pounding of her heart, which seemed suddenly to recede somewhere deep inside her ribcage, cowering.

She didn't move as he pulled himself gently forward, so that he was sitting directly across from her. She unfurled her legs from beneath her, the swish of her stockings against the silk of her skirt harsh in the otherwise silent room. They sat there a moment, knee to knee, and he let his other hand settle on her opposite thigh, bracing himself.

"_You _are not to blame," he said steadily, not lifting his gaze from her eyes. "_No one_ will blame you for this," his voice dropped away to a near whisper as he realized why she was so distraught. He reached up and brushed her hair from her eyes, "_Anna will not blame you for this_."

She came unraveled, then, bringing her hands to mouth to quiet the sob that was no longer content to lay in her throat. The room began to fade away and she worried that she might faint, that she might disappear, dragged into the fear that had suddenly consumed her.

Then, she felt him press his forehead against hers.

"You're okay," he said softly, "_It's all going to be okay_."


	22. Fracture

**A/N: **You guyyyyys. So amazing; each and every one of you! Thank you for all your reviews, your love on Tumblr, and for continuing to message me to 'check in' to DH. You keep the fic alive! Just so you know there is definitely more drama in this chapter. Things have to get worse before they can get better!

This chapter has a **trigger warning** regarding post-traumatic stress, recovery from assault and could be triggering for anyone who has ever been involved in a lawsuit surrounding assault and battery, attempted rape, etc. I'm not entirely versed in England's laws and process, so feel free to leave in your review any corrections you may have. I am taking some creative license in terms of fitting it into the larger healthcare-focused story, so bear with me. Also, just so everyone knows, Sam (_royaltydowntonandlife on tumblr_) is completely aware of where her plot is going and has _volunteered as tribute_, so to speak, so yes— she's okay with it! :)

Oh, and there are a few notes at the end. But as always, please do ask if something isn't clear or if the medical jargon isn't explained well enough in the dialogue.

* * *

"_You must be little Annie," the man in the white coat says. _

"_It's Anna," the blonde haired girl says, her eyes unblinking._

_He kneels down, fills her field of vision. She hears a baby crying in the hallway behind her. Her sneakers squeak on the floors here. Someone gave her a cookie and told her to wait. _

"_You are a very smart, very brave girl," he says, his brown eyes heavy and sad. "Maybe when you grow up you will be a doctor." _

"_Is my mum going to be okay?" Anna says, the cookie beginning to go warm in her hands, the chocolate melting against her skin.*_

"_We don't know," he said evenly, "But she has a much better chance thanks to your quick thinking. I bet she is very proud of you," he stands, pats down his white coat. She watches him turn and walk away, disappearing into the hot-white hallway. The chocolate, sticky against her fingers now, melds with her mother's blood and she tries to catch the eyes of all the grown-ups who walk by her, hoping someone will show her where to wash her hands. _

"Anna? Anna, you're only dreaming. It's okay."

She blinked awake, her head throbbing — _oh, this hell again, _she thought, her eyes adjusting to the dimly lit room. _At least everyone's remembered to keep the lights down._

"I'm awake _now_," Anna croaked, her eyes still bleary from sleep; from everything. She's spent a fortnight in this bed, which was all at once so odd — not remembering at first _the why _behind it, but also finding it peculiar to be seeing the hospital through the eyes of a patient. Daisy reached for a ghastly pink plastic cup, pointed the straw toward her mouth.

"Dr. Hughes should be here any minute," Daisy said, setting the cup down and straightening her scrub top.

"What time is it?"

"Just after five."

Anna sighed wearily. Dr. Hughes had been to see her no less than three times per day, _every day,_ since she woke up. Slowly everything began to piece together. Slowly the swelling in her face went down (though she'd still not been able to look in the mirror, hadn't dared). Slowly, the anger welled up inside of her, bleeding from her like the jagged cuts on the side of her head.

"How are things going out on the floor?"

Daisy blinked, "Oh, don't worry about any of that —"

"I'm not worried, just curious," Anna coughed, "I'm eager to get back to it. I miss it."

"We miss you too," Daisy said, "It's kind of weird to see you. . .here, like _this_."

Anna smiled. Something had changed for Daisy "the intern." More and more Anna looked at her and saw, simply, Daisy _the Nurse._ "It's strange to be seeing everything _from _here—"

The door clicked and they turned, Anna not so much turning as letting her head loll against her pillow. Dr. Hughes came bustling in, her arms overflowing with textbooks, charts. Anna squinted, blinked a few times. She flicked her eyes up at Daisy and saw a streak of worry cross her face. They both saw it. Probably everyone had.

Dr. Hughes looked _frail. _

She'd clearly lost weight, her cheekbones high and harsh, the shock of muscles in her neck as she turned her head, the way her collarbones suddenly jutted up from beneath her blouse. Her face waxen, eyes dark; nebulous. Lowering herself into the waiting chair at Anna's bedside, she seemed pained to force a smile; more a grimace than anything else.

"How are you feeling today?" she asked, her voice sedate, almost soporific.

"Tired," Anna said frankly, "Tired of being in this bed, in this _room._ . ."

_Tired of everyone pussyfooting around, _she thought.

"Well, I think you'll be able to be discharged tomorrow or next day," Dr. Hughes said, trying to infect her voice with a dose of optimism, "Of course we'll arrange for visiting nurses —"

"And what about the suit?"

Dr. Hughes' face fell. She gripped the spine of one of the large textbooks in her lap. "Well, Downton's legal council has said that Mr. Green should at least be charged with _Grievous Bodily Harm*_, given the extent of your injuries_." _

"What about attempted _rape?_"

"It's not so clear—"

"What's not_ clear_ about it?" Anna scoffed, "He told Tom he _fully intended_ to rape me."

"Anna, I _know_ you're angry and —"

"I'm _more_ than angry," Anna said, wincing. Her jaw had begun to throb again. "You're right, I know, I've got to try to avoid straining these muscles but — _God, where is he_? Why doesn't anyone know where he is?"

"He can't hide forever."

"What does Tony say?"

Dr. Hughes hesitated, "Well, it's not so simple as him. . .having a say_ personally_. Obviously he thinks the situation is wretched, and that Mr. Green is despicable, _a criminal_, and clearly should be punished but —"

"_But?_ There's a but?"

"The hospital is—the _administration is_ —concerned about the ramifications of a suit against not just _Green_, but the company, _Gillingham and Green, _which have major contracts with—"

"What are you saying, exactly, Dr. Hughes?"

"_I'm_ not saying anything — this is just what the _power's that be_ have to say on the subject. Anna, I'll be straight with you — there are many people at this institution who would prefer if you dropped the matter _entirely_ and just got on with your life." she pushed the books onto the foot of the bed and leaned over, laying her hand gently atop the IV port on the back of Anna's hand, "But you mustn't give in to their pressure. You must _not_ let them deprive you of some justice—"

"I have no intention of letting them bully me into letting him walk," Anna whispered, a bit taken aback, "Do you mean to say that. . .that there are people in this hospital, who were there that night, at the gala, they saw _everything_ and – and they think I should let him get away with it?"

Dr. Hughes lowered her head wearily, "I'm only saying that the battle there is to fight only begins when you step out of this hospital room, pet."

Anna sighed, letting her eyes flutter closed. She opened them again when she felt Dr. Hughes grip her hand.

"I will do whatever is necessary," she said quietly, "Do not doubt for one moment that I am on your side."

Anna gave her a small smile, "I know, Dr. Hughes. And I'm grateful for it. I'm grateful for all that you've done for me. But please don't help me at a detriment to your own health. Don't take this the wrong way but— you don't look well _at all._"

"Oh, Anna dear — yes,_ there's _the young lady I know! Worrying after others even when she's the one stuck in a hospital bed."

"I only worry when I'm given _reason_," Anna said, giving her a knowing look. "If this is to be the battle you say it is, I'll need you at your best to help. So please, don't run yourself ragged."

"I won't," Dr. Hughes said, giving Anna's hand a final squeeze before she stood, "Though I'm afraid I have been running poor _Molesley_ ragged in your absence."

* * *

"_Mum_?"

Stumbling out of a dream, Cora slowly opened her eyes. The room was still dark, but she could tell it was early morning — the shower was running in the adjacent bathroom and she felt the absence of Robert in the bed next to her.

"Go back to sleep, I'm just going to cuddle in," Sybil said, crawling over Cora's legs and filling the warm spot that Robert had occupied only moments ago.

Rolling over, Cora yawned, "Are you alright?"

Yanking the covers up under her chin, Sybil nestled against Robert's pillow.

"Can't sleep; _couldn't sleep._"

Cora sighed, reaching over to tuck the blankets tighter around her daughter. Sybil was eighteen, practically a grown up with a semester of university behind her; but these early mornings of crawling into bed with her parents reminded Cora of the many nights she'd done so as a little girl. Of all the girls, Sybil has always been the most tender-hearted.

She'd taken a leave of absence from school and in the weeks that had elapsed since Anna's attack, rarely left the house. She couldn't bear to so much as go to the corner cafe —one of her favorite places—unaccompanied. Fear pulsed from her in all her waking hours; and, as Cora knew, in her sleep as well.

"Can you just talk to me for a minute?" Sybil said, her voice muffled against the downy pillow. She reached out and grabbed Cora's nightgown, stroking it gently for comfort, "I just want to hear your voice. In case I start having that nightmare again."

"I can't promise I'll say anything quite _coherent _this early in the morning," Cora said, rubbing her eyes with the heel of her hands. It was futile to try to go back to sleep. Robert was puttering around in the bath and now that she'd finally begun to look pregnant, she felt as such, her back had begun to ache constantly.

"Read me something," Sybil mumbled.

Cora rolled over toward her nightstand and reached for her Kindle. It was a damnable thing, forgoing real books, but Robert had insisted. It was, at least, convenient for moments like this when she didn't have the wherewithal to get up and walk over to the bookshelf.

"Alright, what shall I read?"

"Anything— well, nothing scary or —_political._"

"That narrows it down a bit." Cora said, flicking across the screen. When she opened the app her finger paused over the selection of recommended children's books. "Look, I can even read you a nursery story. What was that one you loved so much? The little princess?"

"_A Little Princess,_" Sybil said, smiling against the covers. She let her eyes open a moment, peeking over at the screen, "That's so weird— that it's on that _thing._ I can't imagine you reading it to us when we were kids on. . .a_ computer_ or your _phone_ or something."

"It's hardly the same," Cora said, flicking her finger across the screen, "But —oh! Well, here we are. _A Little Princess _by Frances Hodgson Burnett*. And look, it's even got the illustrations."

"That's good, read that one." Sybil yawned, turning over so that her entire face was flat against the pillow, blocking out any possible light that might dare creep into her eyes.

"_Once on a dark winter's day, when the yellow fog hung so thick and heavy in the streets of London that the lamps were lighted and the shop windows blazed with gas as they do at night, an odd looking girl sat in a cab with her father and was driven rather slowly through the big thorough-fares. . ." _

"Mum?"

Cora paused, "Yes, darling?"

"Do you think I'm going mad?"

Lowering the Kindle to her chest, Cora turned her head to Sybil, who had turned _her_ head just slightly, peaking over the mound of covers.

"No, not at all." she said, reaching a finger out to stroke Sybil's cheek, "Do you feel as though you are?"

Sybil let out a shuddering sigh, "I think I might be," she said quietly, "I can't stop thinking about it — about the attack — and it paralyzes me. I feel shaky and sick all the time, every minute of every day and — well, I can't get it together. And I know Dad's disappointed in me, that I couldn't pull myself together and go back to uni, and I know Mary thinks I'm daffy, and Edith," she laughed sadly, "Well, she'd probably like to see me locked up on her unit after all this but," she sighed heavily, "I don't know what's happening to me, it just feels like my brain is a skipping CD, you know? Like it just skips over the same thing over and over again except I can't hit eject."

"I don't think you're going mad, darling. I think you just witnessed a terrible, terrible thing and you're trying to make sense of it. You were so brave in the moment, as it was happening, but," she paused, thinking a moment, "Well, there are _many _ways to be brave, Sybil. And I'm not exactly sure what it is that you'll have to face to get through this—but I know that you _will._"

"Will I, mum?"

"Yes, darling. I promise." she leaned over, mindful of her belly (which suddenly had more of a presence in the bed than it had for the better part of the last eighteen years)* and kissed Sybil's cheek, "Alright then — where was I—?" she lifted the Kindle from her chest and waited for the screen to light up again.

"I should have picked something less girly," Sybil laughed, reaching over and laying a hand on Cora's belly, "Though I suppose he'll have to get used to it, won't he?"

* * *

Mary managed to stall her tears long enough to shut the door of Dr. Carson's office and cross the room to where he sat at his desk, removing his glasses when he saw her appear in the doorway.

"Dr. Crawley," he paused, registering that she'd begun to cry, or rather, had begun to cry _again, _as her sallow complexion implied she'd been tearful for quite some time.

"I'm sorry to barge in on your Dr. Carson but—well, I've really gotten myself into a rather delicate situation and I don't know what's to be done about it. If _anything._"

He sighed, gesturing for her to sit, "I can only assume this is in relation to Anna's suit." Mary nodded, pursing her lips. Charles reached or a tissue and passed it to her. "Or rather, perhaps I am to assume it's more to do with your relationship to Tony Gillingham."

Wiping her eyes, Mary paused, her mouth agape, "I wouldn't say we have a _relationship._"

"Well, you've something. Something that's making it difficult to establish loyalty to this institution and — dare I say, _Anna_; a colleague. Perhaps a _friend._"

"I wouldn't think there's a chance for that now," Mary sighed, folding the tissue and setting it gently in her lap, "I haven't even been to see her. I can't bear it."

"And you suppose she _can_?" Charles said, narrowing his eyes at her, "Dr. Crawley I've known you since you were a child. You've always been a person who lives by their own set of principles, never to be swayed by whatever is _en vogue_. Please forgive me for coming across as unsympathetic but Anna's attack has not just changed her life, but the life of_ every single individual_ in this hospital. A hospital, I will remind you, that is in_ your_ blood. Why you would even consider aligning yourself, your _values,_ with a man like Tony Gillingham is absolutely beyond my understanding."

"_He_ didn't attack Anna," Mary said, her voice cracking, "Mr. Green, wherever and whomever he is, is to blame. Not Tony."

Charles sighed, "Even so, I would question Mr. Gillingham's judgment if he not only employed but worked very closely — in a partnership, in fact— with a man like Mr. Green."

"Might _I_ remind _you_ that you are not my _father_, Dr. Carson, and any opinion you have on the men in my life are of _little_ consequence," Mary sneered, throwing the wad of tissues on his desk.

Charles blanched, the corners of his mouth twitching. "Dr. Crawley, I—"

"I only meant to tell you that my _relationship _to Tony affords me some information— information that I think will be very important to Anna's suit." Mary said, dabbing her eyes with the back of her hand, "And it is this: she needs to know that she is not just taking on a single, evil man: she is up against an entire _industry._"

Charles stood, bracing his hands atop his desk and leaning forward, staring at Mary intently, "And _you_ can tell _him_, Dr. Crawley, that Anna has entire _hospital _behind her," he lowered himself slowly, reaching for his glasses, "Or, as it stands, an entire hospital —minus _one._"

* * *

"What a royal _clusterfuck_ this has turned into," Rosamund said, lighting a cigarette. It had been at least a decade, maybe longer, since she and Robert had stolen away to the roof of the hospital, and about as long since she'd stolen a cigarette from the lockers.*

"You shouldn't light that," Robert said, "You remember how long it took you to quit last time?"

Rosamund scoffed, tucking the lighter back into the pocket of her white coat, "Don't patronize me, _Bobbie._ Either I have something to settle my nerves or you'll have to lock me up on my own ward," she took a deep, satisfying drag, then coughed miserably, "This is the _cheapest _tasting cigarette I've ever had, good _christ, _how much are you paying these poor unit clerks? Can't they at least afford a decent pack of fags?"

"We didn't come up here to talk about your disgusting habits," Robert said, stuffing his hands in his pockets.

"Since when have I needed an occasion for_ that_?" Rosamund laughed, ashing her cigarette onto the concrete, mindful not to get any on her person, "But no, we're not here to talk about _my_ poor decisions." she took another drag, turning to him as she exhaled, "Only _yours_."

"I never said anything to make the defense team think Anna was in any way _asking for it,_" he said firmly, "All I said was that there were two witnesses, and that they would testify. And when they asked and returned with Sybil and Tom they just — well, they drew their own conclusions about what _they _were doing in that hallway, and—"

"So they were having a little _nookie,_" Rosamund said, "What does that have to do with Anna?"

Robert shrugged, "I don't think it has anything to do with it — but Green's not been found, the pharmaceutical company is trying to say that this is all some . . .some kind of s_landerous_ plan on our part to discredit them. . ."

"But why would they think that? We haven't got any bad blood with Gillingham and Green, have we?"

Robert looked down at his feet, stepping on the floating ashes from Rosamund's cigarette.

"Robert? We don't have any bad deals with them, do we?"

"Well, I'm afraid it's not that simple," Robert said, rubbing his temples, "It's come out that. . .that some deals have been cut . . .and, well, there is information out there that has the potential to have our accreditation brought into question."

"Which accreditation?"

"Well, _all of them_. Our operational license, really."

"_Jesus Christ, Robert_!" Rosamund said, wrapping her arms tightly around her chest, "We've got doctors cutting black market deals with pharmaceutical reps? How long has this been going on?"*

"Long enough,"

"And did you _know_?"

Robert opened his mouth, but then gently closed it, his shoulders shrugging.

"Robert —_ did you know_?"

On the street below they heard an ambulance careening toward the hospital's entrance. Robert looked over the side of the rooftop, his eyes lingering on the street stories below.

"I have not always made wise investments—."

"No fucking _shit,_" Rosamund said, pitching her cigarette butt over side of the building, "Now tell me straight — did you know about these deals? Were you _involved?_"

"The hospital has . . .we are in an _enormous _amount of debt as it stands, Rosamund—"

She took a quick step toward him, grabbing his forearm tightly, "Whatever you've done you had better _undo_ it, before it costs that nurse her justice—"

Robert's lip quivered and he exhaled shakily, "I _can't_."

* * *

"Els— do you have a minute?"

Elsie paused, turning at the sound of Beryl's voice as she passed the nurses' station. "Only_ just_. . ." she said.

"Have you checked in on Samantha yet today?"

"I was on my way now — well, to look in on _Stephanie_, actually, though I'm to assume they are thick as thieves, per usual. I wish I could attend doubly to _all _my patients."

"That's just it, though. We've not seen hide nor hair of Samantha. Stephanie's been asking after her but when Phyllis took her vitals last she said her BP had plummeted and she's slept for the last eighteen hours straight."

Elsie's eyes widened, "Why didn't anyone page me?"

"Well, it's been a little chaotic around here without Anna, and with you keeping vigil at her bedside for the last couple of weeks we've been trying to manage but —"

"I'm sorry, Beryl, I know. I know it's been difficult for everyone. Stephanie should be discharged this week and I thought perhaps we'd made enough progress in managing Samantha's flare that she could go home as well," she reached across the counter of the nurses station to grab a chart from the pile Beryl had stacked up, "But perhaps not."

"What about you?" Beryl asked, "When do you get to go home and have a rest? You look like you've not slept or eaten since the Gala."

Elsie sighed, "Save one of those muffins for me," she said, eyeing the basket Beryl had placed in the corner, and refilled every morning since Anna was attacked, "And you know me, I'll sleep when I'm dead." she spun on her heels and took off down the hall.

"Well, by the looks of ya, you've been dead for about a _week,_" Beryl said under her breath, shaking her head as she turned back to her computer screen.

Elsie made her way somewhat unsteadily down the hall, and as she pushed open the door to Samantha's room, she was unsettled to find the curtains drawn and the lights off. It was midmorning, usually by now she and Stephanie, who had made a perfectly reasonable recovery, were up to some kind of mischief, or the very least, chatting over their coffee.

"Samantha?" she said, stepping into the room. She set the chart down on the small mobile table in the corner and made her way to the bed, where Samantha was curled beneath several blankets, her hair unwashed and plastered against her cheek and forehead. Elsie felt her breath hitch and she immediately went to the mobile computer unit, bringing up her most recent vitals.

From the bed, Samantha said something inaudible and Elsie lifted her gaze from the computer screen to look at her, "What was that, poppet?"

Not able to see her in the dimly lit room, Elsie sighed and reached for the light behind the hospital bed, snapping it on. Returning her gaze to the bed, she recoiled slightly; Samantha looked ashen. Moving quickly from the computer, she lowered herself onto the bed and reached for Samantha's wrist, checking her pulse against the monitor; the girl's skin was clammy and chilled.

Inhaling sharply, Elsie stood, hitting the call button behind the bed, then reached up and gently stroked Samantha's cheek with the back of her hand; _still the quickest way to tell if she's febrile,_ she thought*.

"What's wrong?" Phyllis said, jogging into the room, "Did her BP drop again?"

Elsie looked up at her, "How long has she been like this?"

"At least since yesterday, though I think she'd been wearing herself down quite a bit, worrying after her friend and all. . ."

Sighing, Elsie tucked the blankets under Samantha's chin, "How long has she been _febrile_?"

"She wasn't last time I took her vitals,"

"Take her temperature again. She feels as though she's running a temp — has she been able to even get out of bed?"

Phyllis blinked, "No — we had to catheterize her last night*. I thought you'd seen her chart?"

She may well have, but Elsie's head spun with so many thoughts, so many things to remember, that she didn't dare admit one way or another. "I'm going to put in a requisition for another spinal tap. Page Dr. Bates and ask him to come as quickly as he can. If he can't, find out who's on call and get them down here."

"Her tap was clean when she was admitted—"

"I know," Elsie said, pressing her fingers against her temples, "But she also wasn't febrile then, and she was up and walking, talking. . ." she looked down at Samantha and sighed heavily, "I don't think it's M.S." she lifted her gaze to Phyllis, her voice low, "I think I was wrong."

* * *

Charles looked around the empty nurses' station in pedes, then checked his watch against the large digital clock on the wall. It was precisely noon, just when they said they'd get lunch. He looked around again before settling into one of the vacant swivel chairs. He heard a door open, the clicking of heels coming toward him from down the hall and he recognized her footfalls. Straightening up, he smiled, knowing that in a few moment's she'd appear.

As soon as she did, however, his face fell. She looked stricken, and when she saw him sitting there, she paused, her mouth half open and her eyes glazed over, lost in thoughts somewhere else.

"I'm sorry, Dr. Carson. I've lost track of time."

"What's wrong?" he said, pushing himself up from the chair, "Has something happened?"

She hesitated, then took a step toward him, "It's Samantha— the M.S. patient."

"Yes, one member of your Lucy and Ethel duo?"

"She's . . .well, I think I was wrong. About the diagnosis. I don't think it's M.S."

"Oh," he said softly, "What's made you think that?"

"Her condition has deteriorated very quickly. Within the last twenty-four hours she's progressed to extreme muscle weakness, aphasia, poorly controlled hypotension and she's febrile."

"Her initial lumbar puncture was clean?"

"Yes, and it may well be on this run but. . ."

He sighed, taking a few steps toward her, "What's in your differential?"

"That's just it — we've ruled out spinal cord neoplasm, sarcoidosis, Lyme, metabolic disorders, gliomas. . ."

"Have you tested her for JCV*?"

Elsie blinked, "That's associated with HIV/AIDS, Dr. Carson—"

He shook his head, taking her arm gently and leading her down the hall toward her office, "Not exclusively, it can be reactivated in immunosuppressed patients."

Elsie shook her head as she opened the door to her office and took a few hesitant steps in. He closed the door behind them and turned toward her bookshelf, looking for something intently as she settled her weary body into her leather office chair.

"There is a rare condition that is worsened by drugs given to MS patients. I don't know what you had prescribed her, but if she had latent JC virus in her kidneys, the drugs and the immunosuppression would have reactivated it—" finding the text he was looking for, he hefted it from the shelf and brought it to her desk, turning to the index before he'd even crossed the room, "I've never seen a case of it but I recall a study several years back linking it to Natalizumab—*" he thumbed through the pages and read, then, turned the book toward her, pointing to a passage, "Progressive multifocal leukoencephalopathy."

Elsie squinted, reading a moment, then looked up at him, "Well, it _does_ fit her presentation. Particularly the hasty progression and similarities to multiple sclerosis," she flicked her eyes back to the text and frowned. Turning the page, she cocked her head to one side as she returned her gaze to his, "What about treatment, Dr. Carson?"

He turned, sitting down slowly in the chair across from her, looking at his hands instead of recapturing her gaze, "Does she fit the profile of PML?"

"Symptomatically, yes." Elsie said, "We'll test for the presence of JCV, but—" she stopped, noticing that he'd begun to wring his hands nervously, "Dr. Carson?"

He looked up slowly, "There _is_ no cure for PML, Dr. Hughes."

"Oh," Elsie blinked, "Well, how do we best manage it? It says nothing here about managing hypotension and —"

"Dr. Hughes," he said quietly, "_There is no cure for PML_."

She held his gaze a moment, "What are you saying?"

"PML progresses quickly and is always fatal," he said, his voice measured, "If she's already begun to decompensate this rapidly. . ." he sighed, shaking his head sadly, "There's nothing left to do."

"That can't be," Elsie said breathlessly, "There's got to be _something._ She's young, it's not her time — I won't let her die."

"Dr. Hughes," he said, reaching a hand across the table to close the textbook. She slowly pulled her hand from where he'd caught it between the pages, and he could see she'd started to shake, "She's already dying."*

* * *

* If this sounds vaguely like the_ never-ending carousel metaphor_ on _Grey's Anatomy_, it's probably because it's very similar, lol.

* I mean, I would hope they'd _at least_ get him for GBH.

* Was my favorite as a child and yes, I do have the illustrated version of it on my Kindle.

* Time-jump + this is her fourth pregnancy = as far as I'm concerned she's definitely showing by now! Probably somewhere between 16-17 weeks into it because that's what the plot calls for. Yay flexible time-space continuum.

* Ros is turning into my favorite character to write, tbh.

* I wish I was making this shit up but it does happen, probably more than we'll ever know.

* It actually is— Elsie isn't a mother per-se but I recall several nurses I knew who were mums knowing when a patient was running a fever just by looking at them.

* Sorry, Sam. :P

* John Cunningham Virus. We all have it — or at least 90% of us do — laying dormant in our kidneys. Usually it doesn't cause any trouble, however. . .

* . . .in patients with certain immunodeficiencies (like HIV/AIDS) or taking certain drugs prescribed for M.S. (thankfully not so much anymore, as I believe at least a few were taken off the market) it can resurface and cause a fatal condition.

* As I mentioned, Sam knows! It's okay! No one put a horse head in my bed!


	23. Palliative

**A/N: Holy shit you guys, have a told you lately that I love you? I have to admit this fic has started to take over my life, but I love that it's slowly taking over all your lives too, ha! If you haven't had a chance yet, head over and watch the opening titles + the trailer for this chapter on my tumblr (** .com**). **

**I *am* hoping to make a teaser for each chapter from here on out but it's really hard to find the clips I need of the actors - though those of you have have been/are going to be patients who are eager to lend your voice, yes! yes! yes! I will certainly take you up on that. Now if only we could hire the DA actors to read *_their_* lines for us, mwuahaha. A doc can dream. . . :P **

**Also, all my love to Steph and Sam who have been real champs on this chapter — and to **mrpoohnminnie** here and on Tumblr for clearing up some of the legal mumbo-jumbo. I should say that I have never personally been embroiled in any kind of lawsuit involving rape or attempted rape, but good LORD is it frustrating. For anyone who has gone through that, you have my sincere admiration and love. Just writing and researching on it has made me incredibly angry at the system, US and UK, for that matter.**

* * *

"_She's dying?" Stephanie said, "Why did you let me make a friend of her if she was dying? That's rude, that's fucking rude!" Tears falling, she reached up to wipe them away on the back of her arm._

"_I didn't know," Elsie sighed, handing Stephanie a tissue, "Over the last couple of days she's gotten a lot sicker and now that we know what's behind it, we know that. . .that there's nothing we can do for her except make her comfortable," _

"_You're not even gonna try," Stephanie squeaked, "She is the only person who understands how fucked up it is when your family is weird, and they don't notice you, or they only notice you when you fuck up and you just . . .you walk around wondering if you're even real because no one sees you, no one ever sees you — but she saw me! And now you're telling me that she's dying? I can't do this alone, I can't do all this without her — and you knew, you knew that and that's why you introduced us —" _

"_Stephanie, I am so sorry. I know how frightening it is to face things without —" _

"_You don't fucking know anything!" Stephanie cried, slamming her fist against the bed, "You should have known she was dying and — and saved her. That's your job, you're supposed to save people and," she coughed miserably, her sobs catching in her throat. She couldn't speak through them anymore, all she could do was look helplessly at Elsie._

_So, Elsie did the only thing she could do. She reached over, wrapped her arms around the girl, and let her cry. _

The scene had played out in her head all night, and as she parked her car, she hesitated as she reached for her briefcase, reaching instead for only her purse. Without the heels to announce her presence, she passed through the halls somewhat undetected at such an early hour. She was lethargic and suitably grumpy from having had no coffee, no breakfast. Someone handed her a hospital gown, a pair of slippers, a bag for her day clothes.

Dr. Clarkson had finally managed to corner her, with Dr. Carson in tow, pressuring her into having her lumpectomy.

"_I can't, not now, not this month — I don't have time." _

"_Then you need to make time," Dr. Clarkson said, removing his glasses in exasperation. "Why are you suddenly so against this procedure?" _

_"The truth?" Elsie said, her eyes darting to Dr. Carson's face, "I'm a coward." _

_"I don't buy that for one second," he said, shaking his head,_ "_Dr. Hughes, wouldn't you much rather have this all behind you?" he urged, albeit gently, "Look, I'll do whatever I can to accommodate you. I'll do it tomorrow if —" _

"_Fine!"_

"_Fine, what?" _

"_Let's do it tomorrow." she turned to Dr. Clarkson, "How long of a recovery?" _

"_A day or two at most, you'll be sore but if there aren't any complications—" _

"_Fine," she said, standing, "I shall see you both tomorrow at 8 am." _

And that's how she found herself shaking on a gurney, pulling the paper-thin hospital gown tighter around her. They'd put her IV in but not yet given her pre-operative sedation. Sitting up on the bed, she listened to the din of the pre-operative unit. Nurses chattering, squeaky wheels, monitors. It was oddly comforting, and it was the only comfort. She gripped the flimsy mattress of the gurney, wishing she had family nearby. Last night as she'd held Stephanie, giving her shoulder to cry on, she'd wanted to tell her that she _did_ understand, very much, how it felt to be alone and afraid. She had been feeling it, heavy in the pit of her stomach, since she lay down to try to fall asleep ten hours ago. Felt it as she drove across town to the hospital. But she was a grown woman, Stephanie was so young; _of course_ she was afraid.

When Elsie had arrived an hour or so ago, changed out of her day clothes and into a gown and robe, she'd seen families in the waiting room, milling about, sipping cold coffee, looking worried mostly. A few just looked like they'd not slept all night. She sighed, letting her eyes close. _No point in feeling anything about it, _she thought, _it is what it is. What it's always been. _

She opened her eyes with a start when she heard footsteps pause outside the curtained area where she was seated. Dr. Bates peaked in, brandishing a syringe.

"Good morning, Dr. Hughes," he said brightly, "I'm here to rid you of all your troubles."

She gave him a small smile, "If only it could be so simple."

Laying back on the bed, she gave him her outstretched arm, knowing the drill.

"Not that I suspect you'll need it but we always do give a bit of intravenous Zofran with the sedation, just in case you have any nausea from the anesthesia."

"Well, much appreciated Dr. Bates," Elsie said, letting her head rest against the scratchy pillow as he injected the sedative into her IV port.

"You should feel that pretty quickly, then I guess they'll roll you in. . ."

"Oh, no, no," Elsie grumbled, moving to sit up, "I'll bloody walk.*"

* * *

Elsie passed through the OR room doors, the initial sedative starting to make her a bit unsteady on her feet. The nurse who had her by the arm gave her a reassuring squeeze.

"Wow, you weren't kidding," Dr. Bates said, standing from his seat at the head of the operating table, "Have you started to feel that Versed* yet?"

Elsie smiled drowsily, "I rather think I have," she said, the bright lights of the operating theatre stinging her sleepy eyes. "I'm ready for a lie down."

"Hop right on up," Dr. Bates said, extending his hand to her and helping her to lay down. He gently began to arrange her in the proper position, her arms spread out to each side, gently restrained against the arm rests. He reached for the O2 mask but Elsie shook her head.

"_Please_— wait until Dr. Carson arrives. I'd like to speak with him before you put me under?"

Dr. Bates nodded, settling back into his chair. The nurses buzzed around her, tugging at her gown, beginning to prep the sterile dressing. She could hear the clanking of surgical tools being lined up on the tray next to her. She let her eyes flutter closed, imagining each tool that would be used_. Scalpel. Small retractors. Artery forceps. _

"Oh,—_Dr. Hughes!_"

She blinked, her eyes bleary as she looked up at saw Dr. Carson had appeared above her, illuminated sharply by the overhead light.

"I thought you'd be thoroughly anesthetized by now," he smiled, "The scrub nurse said you walked in here on your own—which shouldn't have surprised me, but I admit— I _am _impressed."

He reached down and took her hand, squeezing it reassuringly. Her arms restrained against the table, she couldn't pull away.

Not that she _wanted_ to.

"I. . .I had something I wanted to _say _but. . .the preoperative sedative has made me foggy and . . ." she laughed, "I don't recall what it was."

"Well, that's alright. There will be plenty of time to chat when you wake up." he flicked his gaze up at Dr. Bates, "I suppose we'll go ahead and begin"

She forced her eyes open wider, clenching his fingers as he began to lift them from her grasp, "Dr. Carson," she breathed, "This-_this isn't what I wanted to say_, at least I don't _think_ it was, but Samantha — when she was _well,_ when she and Stephanie were _both well _and tittering on, they said — they told me that as long as you don't see any _nipple_—this won't be _weird._" *

From above her head, she heard Dr. Bates swallow a laugh. She wasn't exactly sure what she was saying, but she felt her mouth moving and knew she was speaking.

"Dr. Hughes, since you will not remember _any_ of this, I can freely say that even if I _did_ see more of your breast then intended, it would _not _make this weird. With that, I bid you adieu until I see you in recovery."

He made to move his hand, but she gripped it tighter, her eyes growing heavy. "Thank you for doing this." she said. Dr. Bates reached down to place the mask over her face.

"You needn't thank me," he said, leaning in so that he could speak quietly. He paused, watched a moment as her face relaxed, "Now, close your eyes and imagine the most wonderful place you can think of."

He sighed, lifting his face to the attending nurses, "The lump, which is to our knowledge benign, has been identified superficially on the skin with marker," he started, "I will proceed with a direct, downward incision—without lifting of skin flaps—in accordance with established techniques for benign lumpectomies."

The nurses watched him intently; usually they would roll their eyes at his sense of _occasion,_ but not today. It was clear that he was operating not just on a colleague, but a _friend. _The stakes were high and his explanation, his vocalization, was as much about calming himself as educating. They lowered their gazes, busying themselves with checking and re-checking the tools. To look upon him felt as though they were interrupting his conversation with God.

He wasn't explaining, he was _praying. _

A small smile tugged at his face as he realized that he could see the darker pink areola of her breast—but not the nipple. _God, I hope one day we have a laugh about that, _he thought, the latex of his surgical gloves preventing him from feeling the soft skin of her breast as he gently laid a hand upon it, steadying it. His scalpel hovered over the surface, and he hesitated a moment before pressing it against the blue _X _that marked the excision site.

As he separated the fascia of her breast and the tumor came into view, he wondered if he'd ever see the scar. _Outrageous, _he chided himself, _stop thinking like that. _He exhaled sharply against his surgical mask, his own wet breath moistening his upper lip. Staring at the tumor, he nodded to Dr. Bates.

"This will be uncomplicated," he said, making no attempt to hide his relief, "It has _not _invaded the surrounding stroma. How are her vitals?"

"Perfectly fine," Dr. Bates said, his eyes smiling, "She's tough."

"That she is," he said, lifting the tumor from the incision and depositing it into a waiting bin. He let his eyes wander up to her face; she looked entirely at peace. He wondered if she looked so beautiful when she was asleep, at home in her bed. Having let his gaze linger too long, he cleared his throat, working the crick from his neck, "_Well._ . .I suppose I'll go ahead and close."

* * *

_All she hears at first is the crashing of waves, the pulse of the surf whooshing through her ears. Her eyes open gently and her surroundings come into view; the beach, late summer, the breeze light enough to carry the salty scent of the sea but not chill her. She hears gulls circling overhead, the faint but growing laughter of small children. A red-haired woman is walking toward her. She is tall, barefoot, with_ his _coloring. _His_ easy smile. As she comes closer, Elsie feels like she's looking into her own eyes. _

_The woman smiles, her teeth straight and sparkling. She wears little makeup, her skin sun- kissed and freckled. "How do you feel, mum?" _

_Elsie studies this woman a moment and feels an expansion in her chest; it's not pain, exactly. Pressure maybe. A memory? Something pulls inside her and she reaches a hand up, caresses the woman's smooth skin with her hand, and certainty blossoms within her._

This woman is her daughter.

_She looks out toward the crashing waves, sees a man around this woman's age darting in and out of the crashing surf, lifting a little girl up toward the sky. He catches her eye, smiles — _Oh, and with _his_ brow and _his_ hair and his _nose, _God help him!_— she struggles to catch her breath, lowers her hand from the woman's face, lets it fall where someone has laid an afghan gently across her lap. She is warm and the sun is making everything sparkle around her. _

_The man jogs toward them, pausing only to lift the little girl onto his hip. The woman sits down on a blanket in the sand, reaches for a camera. As the man comes closer she knows _this is her son_, the little girl — _her granddaughter_? _

"Give grammy a kiss_," he smiles, setting the girl down. Before the little girl has even taken a step, she feels a hand on her shoulder and immediately her body recognizes it, softens to the touch. She turns her face up just as _his _lips meet hers, soft and grateful. When she opens her eyes, she can't help but lift her fingers to _his_ lips — buzzing like an electric current. _

"He meant _me_, granddad!_" the little girl squeals, climbing up into Elsie's lap, kissing her lightly on the cheek; her skin still baby-soft, her hair smelling of salt and the sweet breath of childhood. She wraps her arms around the little girl, pulls her against her — but her chest, her breasts, are sore, and she can't hold her there long, though she wants to. The man sees her wince, takes the little girl into his arms, lifts her onto his shoulders. They run back toward the surf, the red-hair woman (_her daughter!_) gets up, brushes sand from her strong, bare legs, runs after them, the sun casting a glow onto her hair (_so, so very red like Becky's, just like Becky's!_). _

_He takes her spot on the blanket, reaches over and smooths a flyaway hair from her eyes. Lets his hand come to settle atop hers on her lap, pauses, lifts it gently to his lips. _

_He'd not said picture the most wonderful place you _know_, but the most wonderful place she could _imagine_— and this; _this _was it._

* * *

Cora sighed, watching Mary dab her eyes. She had not been able to conceal her surprise when her eldest daughter had appeared, in tears, in the kitchen. In the middle of the day, no less. It was very unlike Mary to drop in, certainly not in the middle of the week.

Certainly not in tears.

"Oh, darling, we'll figure something out. . ." Cora said, knowing full well that her words were unconvincing.

"I don't understand why Dad won't help; he won't even _listen_. And I know I've disappointed Dr. Carson," Mary sniffled, "I don't think _he'll_ ever forgive me."

"Oh, he will. He cares very much for you." Cora said, shifting uncomfortably in the hard-backed chair, "And as for your _father_ — well, I'm sure he's only trying to balance the responsibility he has to the hospital with wanting very much to support you, to be supportive of his family, and of Anna. He's trying to reconcile a lot."

"I can't help but feel like there's something he's not saying," Mary said, "I've never known him to be secretive but — when I went to him with all this, he seemed beyond distracted. It was almost as though —" she shook her dismissively, "Well, I don't know. Something just doesn't feel right."

"I don't know what to tell you, Mary." Cora said, "I don't know anything you don't already know. I just know that your father is trying to do right by _everyone_."

"He always does," Mary sighed, resting her chin on her hand, "I just wish I didn't have this sinking feeling that the worst of all this is yet to come."

Reaching over to take Mary's hand, Cora paused, letting her hand tremble halfway across the table. Mary looked up from behind her tissues, eyeing her mother uncertainly.

"Are you okay?" she asked, reaching her hand out to take her mother's, gently lowering it to the table. Slowly, Cora brought her other hand down, pressed it against the side of her belly.

When she flicked her gaze up to Mary's, a small smile made it's way across her lips. "It's just — the baby. I — I felt him. I felt him move."

Mary blinked, "Oh — oh, well that's—"

Pulling her hand from Mary's and bringing it to her chest, Cora exhaled deeply. "Oh, thank God."

"Mum, were you _worried_?"

"Oh, well, not really _worried _it's just — well, I thought I'd have felt him earlier is all. But he's there. He's fine."

Mary lowered her gaze, folding her tissue up neatly and setting it on the table. "That must be a great relief."

"It is," Cora whispered, "It's a wonderfully strange thing," she looked up, "Mary, come here."

"No, no — I should be going," Mary said standing, "You don't have to mention any of this to Dad—"

"Mary, _please_," Cora said, "Come _here_."

Taking a few awkward steps around the kitchen table, Mary hovered at the side of her mother's chair.

"Give me your hand,"

"_Mum_—"

"Mary Josephine Crawley, give me your hand," she laughed, reaching for it. She placed it gently onto her stomach, covering it with both of hers.

"Mum, come on, I—"

"_Shh. Wait_."

Mary felt her shoulders tense with discomfort, but she held still. She waited. She was primed to yank her hand away when she felt it — a tiny, nearly imperceptible thump.

Cora looked up her brightly, "See?"

Mary did pull her hand away then, shaking it out, as if to shake off the memory of what she'd felt, of what they had just shared.

"Mum — just don't tell Dad I came by, alright?"

Cora's face fell, but just as Mary crossed the threshold of the kitchen she found her voice long enough to call after her, "I won't, darling."

Mary quickened her steps, trying to make it to her car before she began to cry.

"_I'm very sorry, Dr. Crawley. Perhaps later, down the line, there would be a possibility of IVF. . ." _

"_Medicine is not a business of miracles, I'm afraid. Given the extent of the damage, pregnancy would be extremely unlikely." _

"_You would be a candidate for a partial hysterectomy, but that would make infertility definitive." _

"_At present there is no cure for endometriosis, Mary. You can manage the symptoms. There are medications, surgeries — but if you refuse a course of Lupron, refuse another excision procedure, I'm afraid there's nothing more I can do for you." _

"_Again, I'm very sorry." *_

* * *

"I _know_ why you're here," Anna said, "And I'll save you the trouble: Post-Traumatic Stress, but other than that, a reasonably well-adjusted twenty-eight year old woman with no prior history of mental illness despite having several traumatic childhood events, _which I may add_, I worked out with an analyst when I was a teen. I already take Paxil*, so you might as well not bother offering me anything else. They've been giving me an Ativan drip at night for the nightmares and I'm sure I'll have some p.r.n.* when I'm discharged. Now, please excuse me if I'm coming across as rude, but I am really not interested in talking to _any_ member of the Crawley family. Not now."

Rosamund looked down at her lap, then lifted her gaze only after she was sure Anna had said her piece, "I'm not here as a doctor."

Anna held her gaze, challenging. "Why, then?"

Sitting back in the chair, Rosamund crossed her legs, sighing. "I'm here, Anna, because you need to know that there is _someone_ in this hospital who will not be swayed, who will not allow the administration to convince them that you should forgo your suit for the greater good," she licked her lips contemplatively, "And I will say, Anna, that this goes far beyond what happened with that man the night of the gala."

"What do you mean?"

"This hospital is about to be embroiled in a legal battle of _epic proportions_, one that will threaten the foundation, shake the ground beneath us in ways you cannot even_ begin_ to imagine —"

"Because of Mr Green?" Anna said, shaking her head, "Because — because of the_ lawsuit_?"

"No," Rosamund said sternly, "Because of what it will expose about this hospital's relationship with that pharmaceutical company. Anna, darling, I'm going to make but one suggestion: sue the company, not the man who did this to you. He very likely has absolutely nothing that you want, and to sue for punitive damages might deprive him on a Lexus, but you can do much better than that—"

"I still don't quite understand—"

"I've probably already revealed too much," Rosamund said, smoothing her skirt as she stood. She reached up to twist her earring nervously.

"I don't need to sue the company, I'm not doing it for the _money_, I just want him to be punished for what he did to me — for what he_ tried t_o do—"

"He will be," Rosamund said, leaning down mere inches from Anna's face, "But he's not the only one who needs to be avenged."

* * *

Charles furrowed his brow, grabbing at a passing nurse as he stood aimlessly amid the coming and going patients in recovery, "Was Elsie Hughes discharged?"

The nurse blinked, "No — well, not to _my_ knowledge. The last time I checked she was having a bit of tea and toast. We'd like to get her pain controlled before we send her home."

Sighing, Charles ran a hand nervously through his hair, "Well, she wasn't in the room they put her in after the surgery — _which I performed,_ so, I don't know how she could have been _lost._"

"I'm sure she's not been _lost_, Dr. Carson. Perhaps she's taken a walk —? Would someone have come to see her—?"

He thought a moment, then jolted, his hand gripping the nurse's arm, "Oh — _oh, no_, not someone visiting _her_ — she's gone to see a patient."

* * *

The room was so dark she stumbled a bit, the only light that from the many monitors that Samantha was attached to. Elsie approached the bed slowly, her body aching with every step and her eyes fogged from leftover anesthesia and sedation. She reached for a chair, but there wasn't one. Samantha's family had been in and out all day, and were now tucked up in the inn attached to the hospital, reserved for families of patients who needed to be close by; perhaps they'd moved it. She lowered herself onto the bed, careful not to jostle the girl, though she knew even if she did, she wasn't likely to be responsive.

"I'm so sorry," she rasped, her breath heavy in her lungs. She watched as Samantha's chest rose and fell with caught breath. Squinting up at the monitors, she noticed her O2 saturations were dropping, and she felt her own breath hitch hard in her chest, "Oh, oh, Samantha, darling girl, don't go just yet. _Please_— let us tell your family—" she said, reaching desperately for the call button.

She tried to lift her voice, to call out to a nurse, but her own throat was so raw she hardly made a sound. The heart monitor jumped and tumbled over itself as the chaos of dying ensued. How many times she'd presided over a patient's final moments, but not like this, with the sound of her heart beating so loudly in her own chest, knowing that she hadn't done enough.

She had always done _everything she could, _and that was her integrity, _her promise. _She tried to call out again, and if she made a sound she couldn't hear it over the pulsing in her head and before she could think better of it she reached down and lifted the girl's frail body into her arms. As she pressed her against her, the fresh incision in her breast seared, and she felt it tear and begin to bleed against her hospital gown. _You deserve this, _her mind said, and she cried out, embracing the girl harder.

"Let me feel this. I'll bear the pain and you can go—" she whispered, soothing her hair, "I'm so sorry, _oh my God_ —"

"Dr. Hughes?!"

She heard footfalls in the hallway, the door opened and light streamed in, bright and unforgiving. She closed her eyes tightly, but the tears fell anyway, burning her skin as they trailed down her face. She felt someone lift Samantha from her arms. Around her, the monitors blipped, someone asked if there was a do-not-resuscitate order, the conversation whirled, and someone lifted her by the arms, lead her to a waiting chair.

She sunk into it, struggling to open her eyes, to see in the dimly lit room, to hear in the cacophony that had erupted.

Then, she felt it. Someone next to her, a hand on her face. She did open her eyes then, saw him through her tears, looking at her as though _she_ were the one dying, as though _her_ soul was leaving through her eyes and if he only stared long enough, he could trap it.

She pressed her hand against her breast, felt the hot blood seep into her hand. She let herself fall forward, resting her forehead against his shoulder.

"_Please,"_ she cried, reaching her arms up shakily to wrap around his neck, "_Take me home."_

* * *

* I love that you guys love my notes at the end, I like doing them. Anyway, so yes, I stole this from personal experience working in a hospital alongside docs who would go in for minor procedures, docs operating on their colleagues, and they would be like "jfc I'll just walk, don't make a scene!" and I felt like Elsie would do that.

* Versed is the brand name for Midazolam, which is basically a sedative, kind of like ativan.

* If you've never had pre-op sedation let me just tell you that it makes you pretty damn loopy if it doesn't knock you straight out, ha. This chapter is so fucking tense it needed it a little comic relief. _Viva la PG13 Booby! _

* I, unfortunately, have this disease (or, at this point, more specifically, reproductive organ damage that is irreversible) and one thing that every doctor (colleagues and my own personal physicians) has said (and it is an antiquated line of thought) is that endometriosis is a "career woman's" disease. Now, that being said, it doesn't have a cure but it doesn't always equal infertility. . .so fear not, there's still hope for Mary, she just doesn't know it yet. Also, all the lines she was hearing in her memory from doctors were all said to me during the course of my treatment, which is perpetually ongoing. But I think, or I hope, that we all can see why this has all been so hard for Mary.

* This is not an arbitrary mention. Don't forget this drug.

* p.r.n — dosage instructions on medications, means to "take as needed"


	24. Recovery

**A/N: I love it when you guys message me all like "when are you posting the next chapter?!" because first of all it keeps me writing on a semi-regular schedule and secondly, it makes my heart happy to know you're all waiting on pins and needles for the next lil' episode! :) Also, for this chapter, I've gone back to doing some notes at the end because so many of you seemed to enjoy that. As always, if you have questions, message me here or on Tumblr (dr-chatelaines) and I'll do my best to clarify. We're moving at a most glacial pace here, but I hope you trust in me that everyone will end up where they need to eventually!**

* * *

She'd fallen asleep in the car, which didn't surprise him because she'd needed to be sedated while he'd repaired her sutures and, subsequently, to quell her crying. When he realized that she'd driven herself to the hospital earlier that morning, he furrowed his brow deeply. How had she planned on getting home? It had technically been up to him to discharge her, though he hadn't considered that might entail getting her home safely. But he'd not hesitated when the nurses helped her into his car, her head lolling sleepily to one side as they buckled her in. He'd driven slowly, about five miles under the speed limit the entire way to her flat, wincing himself at every bump and jostle. The night was dark and cool around them and as he stole an occasional glance at her (_at stop lights, yields, long stretches of empty road_) he saw that she was shaking slightly (_post-operative shivering, from the anesthesia_)*.

When he parked in front of her flat, eyeing the front stairs to the building, he decided very quickly that it wasn't worth waking her to try to lead her up. She was too sleepy to protest as he lifted her into his arms _(Oh, and she had lost weight, hadn't she? She'd looked smaller, her eyes a bit sunken in, the veins atop her hands more pronounced, but now he felt it. Not that he'd ever held her before, nothing to compare he supposed, but somehow he could feel it) _and only set her down, leaning her like a rag doll against her front door, as he rummaged through her purse for her keys_ (fascinating thing, a woman's handbag; an array of pens, two tubes of hand cream, a leather wallet that may well have cost more than the purse itself, several crunched up medical journal articles and a copy of All The Light We Cannot See, which made him smile. Of course she would read Pulitzer winning fiction*.) _

Easing into her apartment, having guessed the key on the second go, he struggled to find the light switch. He vaguely remembered the layout from his previous visit, and it was small enough an apartment that he figured he could find her bedroom without much difficulty. Leading her step by step down the hall, her head heavy on his shoulder, he wondered what was hurting her more: the incision or the ache in her heart over Samantha. Or maybe it was an even older wound than that, just made fresh.

He hovered outside what he presumed to be her bedroom; it occurred to him that he might well be overstepping in some unforgivable way. She whimpered next to him, knocking him back into awareness, and he realized he had no choice. So, he pushed in.

The overhead light wasn't particularly bright and cast her bedroom in golden hues; the décor earth tones. While the walls and bric-a-brac were tidy, there was a certain unkempt quality that made him feel as though he was seeing her in a way that she would be horrified by. Her bedsheets were tangled up, the blazer she'd worn yesterday strewn across a chair, a few pairs of shoes scattered on the floor. Books stacked up on her night stand. A stale cup of tea.

He lead her to the bed and eased her down, realizing then that he ought to at least get her out of her jeans. She'd had the presence of mind not to wear a bra, so he supposed that he could technically let her sleep in the sweater she'd worn. . .but it wouldn't be comfortable, and it had her blood on it now, and perhaps . . .perhaps he should soak it. So it wouldn't be ruined. He could do that much, couldn't he?

His gaze caught on what appeared to be a discarded nightgown at the foot of the bed. He cocked his head quizzically at it; it was rose colored with cream lace at the hem. He reached for it, shook it out. The cotton was cool against his fingertips, worn but by no means in rough shape. It had a square neckline, also with a bit of lace, and tiny buttons down the front. Looking at it, then at her, than back to the garment, he reasoned that he really ought to help her change into it. The reaching and tugging of her arms would, no doubt, pull at the muscles of her chest, irritate her breast further. If he helped—

"_Ouch_," she moaned, struggling to open her eyes. As they focused on his face, where he stood over her, nightgown in hand, she worried her brow in confusion, "Dr. Carson?"

"I'm going to help you tuck in," he said, "I was wondering— perhaps you'd prefer to put your night dress on? It would be more comfortable."

She blinked slowly, then sighed wearily, "I suppose you're right," she mumbled, beginning to pull at her sweater. She winced, a hand coming up to her breast.

"You'll be sore," he said softly, "Here — perhaps if we — if we work at it together," he paused, his hand hovering above hers at the hem of her jumper. Before he lost his nerve, but mindful not to move too hastily, he gently pulled her arms one by one out of their sleeves and lifted the sweater over her head. Averting his gaze, he lowered the nightgown over her in one fell swoop; so much so that one arm managed not to make it through. Caught up, she elbowed the material, disoriented. "Sorry," he mumbled, gently guiding it through, "There you are, alright then — and — what about your jeans, can you unfasten them?"

She gave him a look that, had she been less sedated, he may have felt comfortable construing as contempt. After a moment, she reached down beneath her nightdress and blindly worked the button, struggling to kick the pant legs down. He knelt in front of her, helping to inch them down, lifting her feet out one by one.

Her toenails were still painted purple, and for some reason, this made him grin.

She lay down almost immediately, seemingly relieved. He pulled the bedcovers up and by the time he'd tucked her in, she was fast asleep. Taking a few steps back from the bed, he sighed. Turning his attention to the state of the room, he reached first for the tea cup, which he figured he might as well take with him to the kitchen.

He was headed there anyway.

* * *

"Cora?_ What on earth_ are you doing, it's after midnight."

Looking up from the box she'd pulled from the hall closet, she smiled apologetically at Robert, "I hope I didn't wake you—"

Robert shook his head, yawning. "You didn't but — when I rolled over and you weren't there I worried," he said, leaning up against the wall in the hallway just outside their bedroom. He watched as Cora turned back to the box she'd been digging through. Sitting in the middle of the hallway, in the middle of the night no less, gave her a peculiar, ethereal look. Perhaps, too, there was a bit of "pregnancy glow" to thank for that*. "Why've you dug out those boxes?"

Reaching into one of them, she pulled out a tiny pastel sweater. Buttercup yellow, knit, with a little hood. She smiled sweetly up at him, "_Look._ . ."

"Oh," Robert said, taking a few steps toward her and kneeling down, "I see," he squinted, reaching down to pinch the corner of the jumper, "Was this. . .who knitted this, was it one of Isobel's?"

Cora nodded, "For Sybil, I believe."

Robert peeked into the box, shaking his head as he chuckled, "Look how small everything is. Doll's clothes, really."

"I know," Cora said, picking up a tiny pink dress, "And they're all girl's clothes. I've been trying to pick out the more gender neutral pieces but —" she sighed, her thought trailing off. Robert yawned, stretching his legs out across the carpet.

"You've any plan to come back to bed?"

"Not yet," Cora said quietly, "I can't sleep."

"Are you uncomfortable?" Robert asked, reaching over and placing his hand gently on her belly, "I can make you some milk toast —"

"No, not that." Cora said, placing her hand over his, "It's just. . .Mary came to see me today."

Robert blinked, "She came. . .here? To the house? During the_ day_?"

"Yes," Cora said levelly, "She's . . .obviously very concerned about the situation with that nurse, from the gala. . ."

"We _all_ are," Robert sighed.

"Well, she said something that struck me as odd. . ." Cora said, lifting her gaze to find Robert's. He raised his eyebrows expectantly, giving her belly an encouraging rub.

"What?"

"She. . .she thinks that perhaps you're hiding something from her. From. . ._ everyone_, I suppose. She didn't want to think it she just — she had a feeling, I guess."

Robert blanched, swallowing so hard it was nearly audible. He flicked his eyes at at her, worried she'd seen it, which she had of course. She stiffened under his hand.

"Is there, Robert? Is there something you're not saying?"

"It's . . .it's a _very_ complicated situation, Cora."

"No doubt," she breathed, "But. . .well, darling you look as though you're about to be sent to the gallows," she reached a hand over and stroked his cheek, "Your face is . . ."

Robert grimaced, struggling to hold back tears, "It's a right mess," he said, "And I don't think that I can fix it. I don't. . .Cora, I can't tell you. I _can't._"

"Robert—"

"No — I can't, it's . . .not yet. I know Mary's worried and she ought to be, but I don't want to worry you with any of it. Not now," he said, his fingers twitching nervously against her belly. She pressed her hand against his, steadying it. "Cora, darling, I love you —"

"I love _you,_" she said, "And I want to help."

He closed his eyes a moment, feeling a small thump against his palm. He smiled for a moment, but was then pulled back into his deep worry. Taking her hand and bringing it to his lips, he kissed her fingers softly.

"I wish that you could, darling. I wish that you could."

* * *

SYBIL:_ (12:03 am)_

You up?

TOM _(12:04 am)_

Yup. Dispatch. Why are you up?

SYBIL_ (12:05 am)_

I dunno. Nerves. Watching Netflix.

TOM_ (12:06 am)_

Anything good?

SYBIL _(12:10 am)_

Criminal Minds.*

TOM_ (12:14 am)_

No wonder you can't fucking sleep.

SYBIL _(12:16 am)_

It's surprisingly calming; getting absorbed in other people's tragedy.

TOM _(12:20 am)_

That was oddly poetic.

SYBIL _(12:25 am)_

Thanks :) Anything interesting happening?

TOM_ (12:30 am)_

Not yet. I was actually off at midnight but I'm staying on because the person coming to relieve me is late. So, drinking some coffee so I can drive home.

SYBIL _(12:34 am)_

I'd like to see you soon.

TOM _(12:35 am)_

Yeah, I've missed seeing you around. I know after that whole thing with Anna Smith and the gala it was just. . .I guess it's been hard for everyone.

SYBIL _(12:37 am)_

How are you after all that?

TOM _(12:38 am)_

I'm okay. It was kind of all in a day's work for me. I guess it's kind of sad but it's true. I'm used to people seeing people at their worst.

SYBIL_ (12:40 am)_

How do you do it? Like every single day? Don't you get depressed?

TOM _(12:43 am)_

Sometimes it's hard, like when it's little kids. Mostly I just feel like I'm helping. I think I'd feel worse if I had to stand around and not do anything about it. At least I'm trying to make it better.

SYBIL _(12:45 am)_

That makes a lot of sense. And you're really good at it. You were so brave that night.

TOM_ (12:46 am)_

Ah, not bravery, just great training :) Downton's taught me well.

SYBIL _(12:47am)_

It's tried to teach me but I'm not a great pupil, lol.

SYBIL _(12:48am)_

Omg, I think I can hear my parents out in the hall. Wtf are they doing this time of night?

SYBIL _(12:49am)_

I'm gonna go check. Home you get home soon. Call me next week.

Sybil opened her bedroom door a crack and peeked out into the dark hallway. Sure enough, illuminated only by the slant of light from their bedroom, her parents were sitting at the end of the hallway, going through old boxes.

"What are you guys doing?" she said, folding her arms across her chest to fend off the air that was comparatively chillier than her bed had been moments before.

Cora startled, her hand flying to her chest, "Oh! Darling you scared me. Did we wake you?"

Sybil smirked, "No, of course not. You know me, a night owl if there ever was one."

"We're heading back to bed," Robert said, pushing himself up from the floor, "Your Mum couldn't sleep and thought now would be a great time to start digging out baby clothes,"

Sybil yipped, lowering herself to her mother's side and peering into the box, "Oh, let me see! Look at these _booties_ — were these mine?"

Cora laughed softly, "No – I think those were Edith's. Yours were . . ." she dug around in the box a moment and then lifted out a very tiny lilac pair of baby booties, ". . ._these._"

Taking the shoes from her mother, Sybil smiled, petting them lightly, "They're so tiny. I can't believe I was _ever_ so tiny,"

Cora lightly touched her finger to the tip of Sybil's nose, "Well, you were, but not for long," she flashed Robert a smile, "Do you remember how fast she plumped up? She was the happiest, chubbiest baby anyone had ever seen. And she had huge, thoughtful blue eyes and everyone would stop and stare at you whenever we went to the market or into town. . .they just wanted to steal you, you were _so_ cute."

"I was never sure if you were delightful because we were easier going parents, after the first two, or if you were just truly a _remarkably_ good natured infant." Robert said, shaking his head, "Either way, you were a very happy, giggly little thing."

Sybil grinned, "Too bad I grew up to be such a hassle—"

"Oh, _Sybil-love_" Cora said, reaching over and soothing her daughter's soft curls, "You're _not_ a hassle."

Sybil lowered her gaze, then looked up at her father, "Dad probably wishes I'd stayed a good natured baby forever."

"Sweetheart," Robert softened, "I know well the line of strong women you were born of and I never had any other expectation from you than one of greatness. . ." he laughed, "—and perhaps some very necessary _ball-busting_ of the patriarchy. And I'm very proud of you for that. Maybe I've not done enough to assure you."

"Thanks, Dad." Sybil said, "I've been thinking. . .I think I'd like to maybe not totally forgo medical school altogether, but, actually, I think I'd rather be a nurse."

Cora shot Robert a look — trying not to look _too _excited, "Oh?"

"Yeah," Sybil said, "I don't really think I could pick just one thing, on specialty, and doctors are. . .well, they have too much damn _paperwork_ to do. And whenever I'm at Downton, really, it's the nurses that are doing everything for the patients. I mean, think of Anna, the night of the gala. She got attacked because she was going to look in on a patient. It wasn't a _doctor_."

There was a moment of quiet between the three of them, and Sybil exhaled deeply before she continued, "I just think that I could do a lot more good as a nurse and. . .well, I think it's more in line with the kind of life that I want." she looked firmly up at Robert, "Maybe you could ask Isobel if I could shadow her at Dr. Clarkson's office?"

Cora reached up and pet Sybil's thigh excitedly, "Oh I'm sure she would be thrilled, darling."

"I'll ask her tomorrow," Robert said, "Perhaps your leave of absence for the rest of this semester would position you to begin in the nursing program in the fall — assuming your final grades would hold up?"

Sybil nodded eagerly, "They would, and I can start applying to programs—"

"Darling, don't worry about that now," Cora said, leaning over to kiss Sybil's cheek. She shifted her position slightly and found that she couldn't quite manage to push herself up from the floor, "Let's all go back to bed — but, if you wouldn't mind, helping me up?" Cora laughed, looking helplessly up at Robert, "It's a good thing you two woke up or I'd have been stuck out here all night."

* * *

John had fallen asleep in the chair in the corner of her room. Anna'd wanted, very much, to wake him. Send him home. Or at least to a more comfortable arrangement in an on-call room. But she liked having him nearby. So many nights of her hospitalization he'd stayed, planted himself in that chair, watched over her. She felt safe. She slept easily when he was there.

She couldn't sleep easily now, though, knowing that she'd go home in the morning. Alone, in her flat. John had offered to stay with her the first night —_ but then what_? She'd thought, perhaps, at the very least Dr. Hughes would be certain to find some reason to pop by. Bringing food, maybe_ (if she even cooked, how could she? Well, Beryl would. Yes, she'd eat well from her handouts alone!) _but other than that she didn't really know who she could count on. Who would she call out to if she woke in the night, imagining that man's hands around her neck? Feeling her skull bounce around as her head crashed into the floor in an endless loop in her body's memory? Would someone help her steady herself when she stood up too quickly and the room spun like a carnival ride she couldn't stop off? Would she be alone?

She'd certainly not call her _Mum_. Even if she did, she knew her step-father would answer. He was the only one who _did _answer. He wouldn't let her Mum or sister have their own cellphone, though she did get an old iPhone for her little sister, just so that she could check in with her by text once in a while. Mallory was about to graduate from uni and had no idea what she was going to do. With a degree in English and History she'd hoped to become a teacher, but Mum wanted her to move home. Help her wrangle their step-father. Anna was hoping maybe she'd consider moving to Yorkshire, or at least somewhere nearby. Mallory always avoided the question though.

Anna hadn't texted her after the accident, and unless the trial became so high profile that it made the London papers_._she had no intention of telling her. According to Rosamund Painswick, it very well might make headlines. She'd urged Anna earlier to "_make her voice heard_," but that would require Anna to know what to say, and at present, she was at a loss for words. Certainly, then, she wouldn't be telling her baby sister any of this. It would only worry her, and besides, it wasn't like she could do anything about it: she was a history geek, not a litigator. Though, after so many years of wrangling their mother and step-father, if the younger Smith daughter wanted to pursue a career in law, she'd make an attorney to be reckoned with.

No sooner had the thought passed through her mind than her phone chimed from her bedside table. _Daisy, _she thought, who was working her first solo overnight shift, _poor thing's probably in way over her head. _Squinting at the screen, she sucked in a quick breath. Mallory's name and picture eerily stared back at her*. The text only said, "_Call me x"_

Sitting up in bed, suddenly unconcerned with whether she woke John or not, she frantically dialed her sister's phone. When she picked up she could hear the tears in her sister's voice.

"What's wrong, love?" Anna said,

"Why didn't you tell me?"

"Tell you what?" Anna said, trying to keep her voice steady.

"That you're in some kind of massive legal battle with some pharmaceutical company! That you're trying to nail them for_ millions_ in damages!"

"What are you talking about, Mal?"

"It's_ all over_ Twitter, Anna*. They've got some picture of you in a hospital bed, with tubes and bandages . . .what _happened_? Are you_ okay?_ Why didn't you tell me?"

Anna felt her heart leap in her chest, "Mal, I'm sorry love, it — it's been a real mess and I don't want to worry you, I don't want to get you involved —"

"Like you didn't want me to get involved with _fuckface?_"

Anna winced at their preferred way of referring to their stepfather. "It's not like that, not exactly. I was. . .I was roughed up. A man tried to rape me, but he was unsuccessful."

_"Jesus Christ, Anna_!" Mallory cried, "Why didn't you tell me? Why am I learning from the fucking _Daily Mail_'s Twitter?"

"I had no idea it. . .I don't know who started talking about it. Who had pictures taken or anything like that. . .Mallory_, I swear,_ I had no idea that this had become the topic of anyone's conversations outside of the hospital and that pharmaceutical company. They don't even know where the guy who did it _is_."

Mallory scoffed, "Um,_ yeah they do._"

"What?"

From the other side of the room, John stirred awake. "Anna, what's wrong?"

She waved her hand at him, "Mallory, _what did you just say_?"

"Green," she said, "The man who attacked you. They found him. And he's saying some guy attacked _him._"

* * *

_No wonder she's lost so much weight, _he thought, closing another practically empty kitchen cabinet. He hadn't meant to go snooping through her flat, but he wanted to get his bearings. He'd found a few afghans and tossed them on her couch; he'd sleep there, just in case she needed something in the night. Certainly come tomorrow morning she'd need something to eat, but he'd have to go out, because there was barely anything edible in the house. Nothing that would sustain her while she tried to heal anyhow. Closing the last of the cabinets he'd inspected, he sighed, rubbing his temples. He was only good in a crisis when he was in a well-lit operating theatre surrounded by scrub techs. Standing in the middle of her dimly lit kitchen, alone, he felt disarmingly out of place. The chaos of surgery, he understood, because there was a protocol. There were rules. He knew what to do if someone was bleeding out, if there heart stopped. Even when something totally unexpected happened, his years of experience made him a necessarily quick-thinker. He could stay calm and collected even in the face of truly nerve-wracking complications. He understood how to save lives, didn't he?

So why did the prospect of saving hers make him feel like an intern?

He turned off the overhead light and headed back into the hallway, pausing as he looked around the den. In truth, the couch he'd made up to sleep on didn't seem terribly uncomfortable, least of all when he was so entirely exhausted. He'd have slept on the floor, even, he just wanted to be horizontal. Yawning, he sat down on the cushions, blinking slowly as he looked about the room. On the bookcase on the wall closest to him, he saw a few photographs. The only photographs that were of _people _that he'd seen. He squinted, craning his neck to look. In a small gold frame was a visibly tattered and faded photograph of a woman who resembled her, and two little girls*. He could see hints of her in the older girl, who looked straight into the camera and all the way through time, straight to him. The woman, who could only be her mother, smiled off to the side, and a younger girl behind her — a bit of a pout, a pretty little thing. _That must be Becky, _he thought.

There was a strange ache in his chest as he looked at little Elsie, and he reached up to rub his sternum as he turned away. Antsy, not quite settled in with just what exactly the night had become for him, he pushed up from the couch and headed down the hall to her bedroom.

He was startled to see she was awake. Still groggy, but blinking up at him tearfully, that heavy and uncertain thing bloomed and ached in his chest once again.

"I hope I didn't wake you," he said, taking a few steps into the room,"I wasn't snooping, I promise. I've just tossed a blanket onto the couch in your den for myself and wanted to take stock of whatever you had for groceries," he sighed, "Or, didn't have, as it were…"

"I _was_ asleep," she rasped, wincing a bit as she spoke, "But the shaking,_ the shivering_, keeps waking me up."

He took a few more steps toward her bed and saw that, indeed, she was convulsing quite noticeably. No doubt a product of anesthesia, the terribly shock she'd had, and her nerves, it didn't immediately concern him as a physician, but it certainly would prevent her from having restful sleep.

"I'm sorry to say I can't give you anymore of that sedative for several hours," he said quietly, "I'm not sure what else I can do for you."

She opened her mouth to speak up but all that escaped her was a tiny, frustrated mewl. She paused, licking her lips and taking a shuddering breath, then, she looked up at him, her eyes pleading, "You could hold me?"

_First line of treatment for post-operative shivering? Warm the patient, _he thought, _that's easy, that's intern level. _If they were still at Downton, he could get heated blankets. Looking about the room, his eyes searched for a heating pad, a hot water bottle, anything. His gaze found a blanket draped over the chair by her window. He wondered, momentarily if you could microwave a blanket. _Don't be ridiculous, _he thought, _you could tumble it in the dryer to warm it up. _He crossed the room and reached for it, but as he turned back to her to ask where her laundry room was, he saw that she'd begun to cry, which only stood to worsen her shaking.

"_Please_," she said, reaching a hand up to wipe the tears from her cheeks. He hesitated, then took a step toward her bed, trying to assess how he'd even go about such a thing.

"I'm sorry, Dr. Hughes, I just —" he paused, blinking slowly. He let his mouth close, tossed the blanket onto the foot of the bed and sat down, taking off his shoes. Laying his head down on one of the many pillows that lined her headboard, he reached for her hesitantly, careful to keep the rest of his body a respectable distance away from her. But as soon as she felt him snake his arms around her, she turned in his arms, curling into his warmth. He stiffened, shocked, and wasn't sure what to do. He was suddenly overcome with a sense of being entirely out of his depth, and he was alone in the fear because she almost immediately quieted and fell asleep. He listened to her quiet breathing for a moment and his eyes grew heavy. It wasn't long before he too fell into a deep, desperate slumber.

* * *

_* Post-Operative Shivering is a bitch. It can be very mild but some people get it so severely, and are so frigidly cold from the vasodilation, that they are miserable far beyond the incisional or surgical pain. _

_*Shameless plug to remind myself that I want to read this. _

_*Let's face it, Elizabeth McGovern is just excruciatingly pretty. Pregnancy glow would just make her ridiculous. _

_* Sybil's that friend everyone has who gets really pissed when they find out you've never seen "The Wire"_

_* What should the hashtag for this be? #DramaAtDownton _

_* First of all I have no idea where the name Mallory came from and secondly, I'm picturing Juno Temple as this character. _

_* I put a manip of this on Tumblr, but my mind saw Lili Taylor as her mum and Georgie Henley circa Chronicles of Narnia as Becky. _


	25. Conscious Sedation

**A/N: Hello darlings! As always, so many many many thanks to all of you who review (and you guest reviewers!) — I'm still making my way through them for the last few chapters! Check out the trailer for this chapter over on my Tumblr (dr-chatelaines) if you haven't already! :) **

* * *

_Something is soft and warm against the palm of his hand. _

_Eyes still closed, he sighs, feeling his chest rise and then — press up against something — someone? There's a faint smell of laundry soap that he doesn't recognize, the bed is so balmy he feels he's part of it, unable to separate his skin from the soft sheets (softer than his by a long shot). His hand twitches against this softness and then — he pauses, presses against it slightly, feels it fill his hand. _

_His eyes open and at first he sees nothing, but feels everything. She's breathing steadily against him, his face nestled against the nape of her neck, the scent of her filling his nose. He's so close to her, his body against hers, that he can feel the curve of her lower back, the rungs of her ribcage. He holds his breath so that he will stop getting closer still each time he exhales against her. _

_She doesn't stir; he lets his hand linger on her warm belly a moment longer, feeling the gentle swell of air giving her life, and then he very slowly raises it, letting it come to settle against his own body. _

_A sadness comes over him and he drifts off into a half-sleep. Soon enough, it will be morning and all of this will wash from his mind; the colors running from a vivid dream._

He'd woken up just after five, as he would have any other morning, and was thankful she was still asleep. As was his left arm, unfortunately. He eased it out from underneath her, careful not to stir her awake, and attempted to get his bearings. Stretching, he walked around the foot of the bed toward the door, reaching down to return a stray shoe to its mate by her chest of drawers. Looking over his shoulder, he paused a moment, studying her. He felt as though he were somehow violating her privacy _("I'm checking to see if her color's good, if her respirations are even. . .") _but he couldn't keep his eyes from lingering; marveling at the way her dark eyelashes feathered against her high cheekbones, the way her lips pouted just slightly in sleep. He sighed, turning away, feeling heat rise to his face as though he'd been caught.

Her flat was very quiet and he couldn't help but envy it. More often than not, street sounds woke him, the occasional passing by of the Tube. She was tucked away on little tree lined street, cobblestones and at this early hour, no one on the streets save for an elderly neighbor walking her dog. He turned back from the window to survey her kitchen. Running his hand along the cool countertops, he furrowed his brow at a few appliances he wasn't sure what to make of: a steel coffee maker, or perhaps espresso? Another chrome object that he presumed to be a toaster, except that it was so large and accommodated so many pieces of bread that he thought it utterly ridiculous for a single woman to have. _Won't be fussing with that_, he thought, turning her oven on low. As he fumbled with the nobs, his eye caught a radio on the countertop. Suddenly he had an image of her standing here, dancing alone in her kitchen while she tossed together a salad, or early on a Sunday morning in her robe_ (he'd seen a terry cloth one in her bedroom)_ while her coffee percolated. His curiosity overcoming him, he adjusted the volume and clicked it on to see what station would emit.

—_Talking it over, just the two of us_

_Working together day by day_

_Oh, _Charles mused, humming low in his chest, _Karen Carpenter, poor girl. And what a voice!*_

_And when the evening comes, we smile_

_so much life ahead_

_We'll find a place where there's room to grow_

_and yes, we've only just begun. _

He glanced up the clock; just before six. Not knowing how long she'd sleep, but knowing she'd be ready for more pain medication sooner rather than later, he opted to make due with whatever he could scrounge up in her cupboards rather than go out. Finding little more than bread, some jam and a questionable slab of butter to make up a breakfast, he did his best to make the finest pot of tea in all of England; as if that was any way to make up for a skimpy presentation of food. He'd offer _— no, he'd just say that he was going out_ — to fetch more groceries for her, see her through the week.

The radio DJ had the dulcet, nostalgic tones of an oldies station and the next song kicked to life, managing to get him humming in earnest as he lifted the whistling kettle from the burner.

_Cherish is the word I use to describe  
All the feeling that I have  
Hiding here for you inside  
You don't know how many times  
I've wished that I had told you  
You don't know how many times  
I've wished that I could hold you  
You don't know how many times  
I've wished that I could  
Mold you into someone who could  
Cherish me as much as I cherish you*_

Her eyes shot open at the sensation of a tight band of soreness around her chest. Blinking awake she was somewhat disoriented at being in her own bed, in her own room. She didn't quite remember making her way home— yet here she was. Struggling to push herself upright, she inhaled sharply, her breath whistling past her teeth as she braced against the pain. The bed was warm; warmer than usual, the far side even filled with comfortable heat. Taken back into a dream for a moment, she vaguely remembered arms around her. As she fully woke and took in the sight of her room, its usual disarray was _tidier_. Shoes lined up by her dresser. Her nights-ago teacup missing from its perch on her night table, and as she looked down at herself, she realized she had somehow gotten undressed in the midst of it all.

Whatever _it_ was.

She reached, somewhat stiffly, for her robe and pulled it around her, realizing at once how terribly parched and _ravenously hungry _she was. She also suspected that somewhere, in her purse perhaps, there would be a prescription for some pain killers. Or, at the very least, she could use a paracetamol.

As she headed down the hall, she caught sight of the couch in her den. Made up as to be slept on. Then, she remembered: _in the car, the streetlights dancing in front of her eyes, feeling the cool plaster of the hallway's wall against her cheek, hearing him dig through her purse, the painful shaking — fitful sleep. Dreams of his voice, his arms and his warmth._

But it _had _been a dream, that bit at least. She lowered her eyes from the den, heard the drone of the radio from her kitchen. Yes, he'd brought her home. He'd stayed over, to keep an eye on her. Make sure he'd done his work up to par, no doubt. But the memory of a warm body against her back, arms holding her tight as she shook, her body coming to life after its medicated sleep.

She paused, her hand rushing out and capturing the doorframe, steadying her. Something else. Not being held, but _holding_. Holding someone to her breast. And blood. The smell of salt air, damp ocean wind and — a girl who wasn't Becky, but was of her essence. She sighed, closing her eyes tightly, pushing it all from her mind. Anesthesia could be a confusing thing, very disorienting. Not to mention she'd been heavily sedated; she could feel it even still. How her hands felt slow and sticky, her legs a little weighted, her thoughts racing in one direction while fatigue kept pulling them back, slowing them so that she _knew _if she were to speak, she would forget whatever she meant to say upon hearing her own voice.

Padding down the hall, she wasn't surprised to see him so much as she was surprised to see what he was doing: buttering toast, sipping tea — and doing some long-ago-learned footwork, his hips swishing gently, to the tune of her kitchen radio.

Which, as she stepped into the room and listened closer, was playing a tune she was at least marginally surprised to learn he liked.

"_The Walker Brothers_, Dr. Carson?" she said, her lips heavy and making her swallow her words.

_Sun ain't gonna shine anymore, moon any gonna rise in the sky.*_

He turned to glance over his shoulder, "Good morning," he said, "Sorry, didn't hear you. I hope I didn't wake up. I was . . ." he reached to switch off the radio, "I was trying to make you something to eat. I imagine you must be hungry. Or, perhaps you're not, but you_ need_ to eat. And seeing as I am your doctor. . ." he stuttered slightly, ". . .who is also consequently in your flat, at the moment. . .well, it's reasonable of me to prescribe you some toast and. . .a cup of tea."

Having caught most of what he said, but not wanting to divulge how sedated she still felt, she nodded and took a grateful seat at the table.

"Did you sleep well?" she asked, rubbing the sleep from her eyes. He seemed to pause, his fingers around the butter knife he was holding, "The couch, I mean," she yawned, "I've fallen asleep on it a few times. It's not dreadful, right?"

He turned slowly toward her, his mouth gone dry. Either she didn't recall the events from last night or she didn't _want_ to. In the event she was trying to rewrite history, he felt his teeth click as he shut his mouth, blinking back toward the toast he was fixing. The last thing he wanted to do was embarrass her.

"I did," he said, and it wasn't a lie. He _had_ slept well.

"Forgive me Dr. Carson," she said, yawning again, "I still feel the residuals of the sedatives and I'm . . ." she paused, furrowing her brow, "Why precisely was I sedated so heavily? I don't recall ever feeling _quite _so hungover as this."

Charles sighed, bringing a plate of toast to the table and setting it down in front of her before returning to the stove to fetch their tea. "I suppose you don't remember much, then?"

She shook her head, her cheeks pinking a bit, "I recall a few things but. . .I admit I don't know how much is reality and what I have to attribute to anesthesia and sedation."

"Well," Charles said, joining her at the table, "The surgery was a success first and foremost. I was able to remove everything and it's been sent off to path but I don't think you have anything to worry about,"

She nodded, taking a bite of toast, "Thank you for that," she said, "Though I suppose I didn't expect to be in so much pain. Was it a difficult removal? Embedded in the musculature perhaps?"

"No," Charles said levelly, "You. . .well, you tore your sutures and I had to repair them. The breast is very vascular and there was a lot of blood* . . .I tried to soak your sweater. It's in the bathroom, in the sink. I'm afraid it might be ruined."

She blinked, struggling to swallow the toast which suddenly seemed irritating to her very dry mouth, "I hope I've not done something _terrible_—"

"Quite the opposite," Charles said, gingerly setting down his teacup, "Your patient, Samantha she. . .do you recall? That you went to see her?"

Elsie bit her lip, "I wasn't sure if it. . .if it was a _memory_ or a _dream_ but. . .I suppose I do," she looked up at him tearfully, "Who signed her death certificate? Has the family been able to retrieve her from the morgue or – will they autopsy?"

"_I_ signed it," he said, reaching across the table to gently put his hand on hers. She looked at it a moment, then lifted her gaze to his and listened, "Everything has been taken care of. They _are_ conducting an autopsy, this morning I would assume. It's the only way they can confirm it was PML."

"I see," Elsie said, letting her eyes fall again to where his hand covered hers on the table. His palm was warm, so much larger than hers. A paw, really. She had a fleeting memory of his hands, but she couldn't trust herself, "I suppose you're not going to let me go in today?"

"_Correct_," Charles said, giving her a small smile, "In any case, I brought you home in _my_ car so, unless you can drive a standard—"

"Oh, I _can,_ Dr. Carson," Elsie laughed, pulling her hand out from beneath his and reaching for her tea. She was startled to find she missed the warmth of him and was happy to have her teacup as a substitute, "I was a farm girl once, remember. I could drive a tractor if necessary."

Charles chuckled, reaching for another slice of toast, "Well, I won't make you harken _that_ far back. Let's see how you're feeling tomorrow. In any case, you can't drive anything — farm equipment or no — until you're off the sedatives and the painkillers."

She winced, "Speaking of, might I have something? Even a paracetamol. I don't want anymore of the narcotics unless entirely necessary."

"Good choice," he said, standing to return to the counter where he'd already laid out the day's worth of doses, "Let's try a paracetamol with breakfast and in a few hours if it's more than you can bear, we'll give the strong stuff a go."

Returning to the table he handed her a pill, then nudged her tea toward her. Much to his amazement, she dry-swallowed it without so much as a cough. She felt his gaze lingering on her and she smiled, leaning back in her chair a bit, "Pills don't bother me, Dr. Carson."

He shook his head, reaching for the tea pot, "So I see,"

A moment of companionable silence passed between them as they finished breakfast. Charles found he had to work at keeping his mouth from turning up into a small grin; if he suspended his belief just slightly, the picture of the two of them sitting in a sunny kitchen having a simple breakfast could have been his life. His life with _her_.

She stood, empty plate in hand, but he reached out and stopped her, "I'll tidy up," he said, taking the dish from her, "Go have a lie down, you don't want to tucker yourself out."

Cocking her head at him, pursing her lips slightly, she laughed, "And what will _you_ do, Dr. Carson? Are you going to abandon me and return to Downton? Surely they can't get through a day without _both _of us."

He looked straight at her, "I won't leave if you don't want me to. They'll have to make do without us," he turned, heading for the sink, "We won't be at Downton _forever_."

"_You've_ plans to be," she said, her eyes twinkling a bit.

"I do?" he said, furrowing his brow.

"Don't you have plans to haunt the halls evermore?"

He laughed, _oh she's teasing me, _he thought, "That is the plan," he said, "What about you? Will I have the pleasure of your ghostly presence?"

She did smile at this, biting it back in hopes she wouldn't blush. Giving him a playful wave of her hand, she turned and headed out into the hall, "Keep calm, Dr. Carson. I'm not dead yet."

* * *

Molesley, thinking he was alone, gave an exaggerated yawn as he finished restocking one of the unit's carts; his last task before he could head home after a rather long double shift. Everyone had been pulling extra weight in Anna's absence, and with Dr. Hughes (and apparently Dr. Carson) out for at least another whole day, everyone had been digging deep for the wherewithal to keep on.

"Promise me you'll not fall asleep driving home?"

He turned, dropping a syringe into the drawer, "Oh, hi Phyllis," he said, smiling at Baxter. Even at his best the sight of the pretty nurse made him titter with nerves, "No, no, I'll be alright."

"Is this all you've left to do before you're free?" she asked, stepping closer.

He nodded, "Restocking. . .I feel like I restock more than I actually use any of this for nursing. . ."

She smiled, "Here, I'll help you. It'll go twice as fast if we both work at it," sidling up next to him she began to pick up various items, gauze, suture glue and the like. They worked quickly and he wished he wasn't quite so fatigued. He'd have liked to come up with some amicable smalltalk, take the opportunity to learn more about her. Maybe ask her out.

"Anna's going home today," Phyllis said, handing him a roll of gauze, "She seems apprehensive. I mean, I would be. Though I suppose Dr. Bates will look after her," she sighed, her eyes a bit sad.

"If anyone tried to attack_ you_ I'd punch them," he blurted, fussing with a tube of suture glue, he winced at his own words, shaking his head lightly, "I . . .that sounded a lot more cavalier and lot less creepy in my head. . ."

Phyllis smiled, giving him a small giggle, "No harm done. I appreciate the sentiment," she nodded toward his hands, "Need some help with that?"

"With what?"

She reached over, turning his hand palm up, "You've glued your fingers together with suture glue, Molesley."

* * *

"I don't want to rush you," John said evenly, reaching across the gear shift to put his hand on Anna's leg.

Anna blinked, shaking herself out of her nervous reverie. They'd been sitting in his car outside her flat for a half hour. "I'm sorry John," she said, "I'm just. . ."

"Don't apologize," he said, "I've only got this one procedure today — then I'll come back, we'll have some supper. It'll only be a few hours on your own and no doubt you'll be thrilled to be home again. Around your own things. In your own bed."

"I am—_ I will be_ but — it's the being alone part."

"I know," he said quietly.

"It's not just this afternoon, I know it's only a couple of hours — it's more — well, what happens when you go home? Sure, you stay around for a few days. Help me readjust. But then I'll be alone again," she laughed bitterly, "Unless I start doing what Dr. Hughes does and sleep in on-call rooms —"

"Well, you don't have to be alone if you don't want to be."

"What do you mean?"

"I mean. . .well, I could stay."

"You _are_ staying —tonight, tomorrow. We've already talked about it. You're not obligated to be my live-in nurse, John."

"No," he said slowly, "But I could be your live-in . . .boyfriend?"

Anna paused, "John —"

"Only if you _want_ to. I'm not trying to pressure you. But we've been seeing each other for. . .quite some time. I mean I'd thought about it even before your attack but . . .I never really had a spare moment to talk to you about it. I mean, we didn't have many moments to spare and when we did," he smiled, "Well, we weren't _talking."_

Anna's eyes lit up and she bit her lip, "John, are you. . .are you saying we should move in together?"

"If you're ready," he said, "Only if it's what you want."

"It is," she said, reaching over and wrapping her arms around him, "My flat's bigger isn't it?"

"By a _mile_," he laughed, kissing her cheek, "But don't worry about it now, we'll talk more later. Why don't we go ahead in, get you settled. We'll fix dinner together later."

"When you get home?" she said, her voice cracking as she smiled wildly.

"Yes," he said, kissing her temple, "When I come _home_."

* * *

"What is even the _point _of Twitter?" Violet spat, folding her arms across her chest as she paced around Robert's office, "Is it a means of communication or a torture device?"

Rosamund sighed, pressing her fingers against her temples, "It doesn't matter — all that matters is that the hospital is now the center of a scandal, one that is spreading like _wildfire_, and that bastard Green is behind it," she glanced up at Robert, "What's he trying to achieve here? I mean _of course_ Tom hit him. It wasn't unprovoked, he was defending Anna,"

"I know," Robert said, "I don't know what he's doing — probably just trying to ruffle us, or more specifically, Anna."

"Is she stable? _Mentally,_ I mean?" Violet said, "Could she stand up court or is she some little slip of a thing that will wilt the moment someone gives her the stink eye?"

"She's tough," Rosamund said, turning to look at her mother, "Tougher now than before, and she wants the fucker the pay."

Violet groaned, "Rosamund, why do you insist on punctuating every thought with a curse word?"

Rosamund rolled her eyes, "Because sometimes calling someone a bloke just doesn't cut it, Mum. Not when the bloke in question is a _cocksucking motherfucker—_"

"_Rosamund Frances Crawley_—" Violet warned,

"An _asshat_, a venerable ass _pirate!_"

"Rosamund, _christ,_" Robert said, "Can we get back to the conversation, please?"

"Sorry Bobby," Rosamund pouted, "Anyway – what can we even do about this? Anything?"

Robert shrugged, "I honestly don't know. I don't even know who to ask."

"_I do_,"

Rosamund and Robert both turned to look at Violet incredulously.

"Don't look at me like that," Violet said, "We've got to ask the youths. Sybil and her friends. Don't they know about _Twittering and Faceblasting and Goggling?_"

Rosamund sighed heavily, sinking deeper into her chair, "Robert,_ help." _

"Actually, that's not a terrible idea. I mean we could at least see if there's any damage control to be done."

"Shouldn't it be going through marketing or PR, Robert? If we're embroiled in some massive legal battle and the press has their nose in it, we can't have your _teenage daughter_ running damage control."

Robert looked down at his desk, "I'm not ready to —"

"I don't think it matters, Robert. This is all coming out, faster than you can hope to clean it up. If you don't get real — with everyone — about what's really going on here, you're going to ruin lives. Not just _ours,_ either," she rose, leaning over his desk toward him, "Do you really want to make that sweet girl, Anna, into a pariah? Throw her to the wolves to save Downton?"

Robert winced, "Do I have a choice?"

"Yes," Rosamund said, straightening her spine and narrowing her eyes, "You always have a fucking choice, Robert. You just tend to choose _being an asshole._"

* * *

"Matthew!" Isobel said, a hand flying to her chest. She'd come around the corner to the waiting room in Dr. Clarkson's office and ran straight into her white coat-clad son.

"Hi Mum," he smiled, "Do you have time to go to lunch?"

She grinned widely, "I can make time. Oh, what a treat," she said, squeezing his upper arm as she passed by him on her way down the hall. Popping her head around the corner of Dr. Clarkson's office doorway, she wasn't able to hide her excitement.

"Isobel," he laughed, taking his glasses off as he looked up from his computer, "What's got you all smiling?"

"Matthew's come by to take me to lunch," she grinned, perfectly chuffed, "I promise we won't be long—"

"Take an hour," he said, donning his glasses again, "Our next patient isn't until two o'clock. No reason for you to putter around here when you could be spending time with your son."

"Thank you," she said, her fingers tapping the doorframe excitedly, "But do text me if anything comes up. We won't go far, I'm sure he's got_ plenty_ to do—"

"Go on," he said, shooing her out the door. She turned just as Matthew came down the hall.

"Shall we?" he asked, offering his arm.

_Oh, I love this boy, _Isobel thought, _his father would be so proud. _

"So, how are you?" she said, giving him a slightly nervous smile, "It's been rather a long few weeks."

He sighed, "Medically it's been fine; socially. . ._ehh_," he groaned, "If I didn't know better I'd say Mary Crawley is jealous of Lavinia, which makes _no_ sense, because she's been insulted by my presence since the day I arrived."

"The entire Crawley clan is under an enormous amount of stress right now, Matthew darling. You can't take anything they do or say personally."

"I suppose not," he said, "Do they know anymore about this Green character? Who attacked the nurse?"

Isobel shrugged, "Only that he's out for blood," she shook her head, "I suspect this is quickly becoming less about what he did to that girl and more about what he thinks Downton has done to _him._"

"What do you mean?"

Isobel paused, giving him a look, "I've been here a long time," she said evenly, "There are some secrets that even_ Violet Crawley_ hasn't been privy to. But I think it's all about to come out in the open," she sighed, leaning her head on her son's shoulder, "But at what cost?"

* * *

"Would you have a look at the grocery list I've made," Charles said, popping his head into the room, "I've got the basics but. . .I thought perhaps you might want something special. Comfort food, as they say."

Having tidied up from breakfast, he'd headed down the hall to her bedroom, only to stop short when he noticed she was sitting in the den.

"Oh, Dr. Carson, you needn't go to the trouble," she said, waving a hand at him, "I'll manage."

"I beg to differ," he chuckled, "You haven't got any food in the house."

She gave him a small smile, "I haven't been terrible hungry."

"That doesn't mean you don't need to eat," he stressed, "I don't mind going to the store. It's a beautiful morning. I could do with a little jaunt around the block." he handed her the slip of paper, "Now, have a look. Make sure everything is to your liking."

She sighed, taking it from him and squinting at it. After a few moments he noticed that she was studying it quite vacantly. Her mind was elsewhere. He reached over gently and plucked the paper from her fingers.

"It can wait," he said calmly, "What's on your mind?"

She gave him a look, surprised and yet somehow _not _that he'd noticed how somber she was.

"I'm starting to recall yesterday's events in earnest," she said, "I feel I must have made quite a scene. With Samantha."

"Hardly," he said, "Her family was relieved to know she wasn't alone. It all happened so fast. . .but she went peacefully. In a situation like that . . .that's all you can hope for."

"I should have known sooner. Obviously my mind was on other things. . .my surgery. Anna's attack. . ." she looked up at him pleadingly, "I can't shake the feeling that I should have done something differently."

Charles sighed, "Even if you'd diagnosed her sooner it wouldn't have changed the outcome. You know that."

"But she would have had more time to . . .I don't know, do _something._ She was so _young._ Surely she had dreams. . .things she wanted to see, to do. If she'd _known_ she was dying. . ."

"Or, alternatively, that knowledge may have paralyzed her. What if someone had told you, at twenty-two, that you were going to die in a few months' time? She lived much of it without fear and, in the end, died — no doubt — in the absence of fear. Because you were there," he shook his head lightly, "When I was her age. . ." his voice trailed off and he lowered his head, humming slightly.

"I can't imagine you at twenty-two," Elsie said, "You must have been in medical school?"

He nodded, "Living in London. Sharing a flat with a bloke I'd known since uni. Turned out to be trouble but that's a different story. What about you?"

"My first year at Cambridge. I'd been in uni back home in Scotland, then mum died. I'd taken care of her service, arranged for Becky's care, broken off an engagement and taken off for London all in the matter of a few weeks."

He raised his eyebrows, "You were engaged? To be married?"

Elsie blushed, "I was. But I broke it off. He was nice enough, I suppose. But after my mother passed away he wanted me to put Becky in a home, marry him, be a farmer's wife. Have a houseful of children, no doubt. He didn't think it would be practical to have Becky living at home with us if we wanted a family of our own. But when I was accepted into Cambridge. . .everything changed. I knew I had a chance, then. I could leave Scotland. Have a chance at a better life — for myself _and_ for Becky. I wanted to come to Downton. Had my sights set on it, really. But Joe . . .he didn't understand."

"That's why you've spent so much of your income on Becky's care. To keep her out of the hospitals and the group homes."

She nodded, "I wanted her to have private care. If she couldn't be at home with me, I wanted her to be with someone who would care about her as much as I do. As much as my mum did. Becky'd always lived alone with us, she didn't go to school with other children. She would have been too overwhelmed living with so many other people. I wanted her to have one to one care and I could have it. . .for a price, of course."

"It must have been hard living so far from her."

"Well, she was in Lytham Saint Anne's. Still is," Elsie sighed, "Closer than Scotland I suppose but still not close enough."

"How did you pay for her care while you were pursuing your studies?" Charles said, shaking his head, "Weren't you in enough debt from school alone?"

"Well, I got my little job at _The Drouthy Lamb_ —"

"Barkeeping?"

"Mhm. Nice little Scot's pub. I went in for a dram, feeling sorry for myself, and they hired me. I'm sure the accent helped. It was still quite thick in those days. I worked harder during those years than I have ever in my life."

"That first year must have been difficult," Charles said, "I had a rough go of it and I didn't have nearly as much to worry about as you did."

Elsie shrugged, "I just put my head down and focused. Worked hard. Didn't think too much."

Charles gave her a knowing look, "Or rather, didn't _feel_ too much. I suspect all you did was _think." _

"You've caught me out, Dr. Carson," she said, "I suppose I'm paying for it now, aren't it? Choosing the life I did."

He furrowed his brow, "You seem to be regretting those choices."

Elsie looked down at her hands, which rested limply in her lap, "I've not been a good friend to you. To anyone, really," she looked up at him slightly, her gaze hesitant, "And I do regret that. Here you are, looking after me, you've not _reason_ to —"

"I've _every_ reason to," he said, a bit irritated, "And really, there's only one reason that matters."

She looked down again, blinking back tears, "What's that?"

Something squeezed his chest and he inhaled sharply, his breath catching in that hollow beneath his collarbones, "I care about you," he said, his voice shaking, "I _worry_,"

He saw her mouth turn up into a little grin, "You shouldn't—"

"Well, I _do_," he said firmly, "Dr. Hughes, pardon me for being curt, but your insistence that you aren't worth a sliver of human decency is very difficult to listen to."

She flicked her gaze up at him, her eyes damp, "I'm sorry, I —"

"Stop apologizing," he said gently, "I'm afraid I don't understand why it is that you believe you are so deeply undeserving of even _basic _human kindness," he said, shaking his head in disbelief, "You are one of the most accomplished physicians in this country, with a mind like a sieve and a heart that beats stronger than anyone I've ever met," he leaned in slightly, "And I have medical evidence to support that,"

She pursed her lips, hiding a playful grin, "You needn't flatter me so,"

He sighed heavily, "Would you prefer that I tell you that you are beginning to hurt my feelings? Implying that my caring for you, _about you_, is pointless?"

Her eyes widened at his sudden sobering words, "Dr. Carson —"

"Just listen, would you?" he snapped. Noticing she'd winced, he softened, reaching over and placing a hand gingerly on her upper thigh, "I don't know who in your life made you believe that you are not deserving of people's compassion, and empathy, and attentions, and care and _lo_—" he paused, stopping himself. She held his gaze, her eyes asking, "_Loyalty,_" he continued weakly, "But it's never too late to stop being defined by the lies that other people have told you about yourself."

"I think I'm too old to change," she whispered, letting her gaze fall.

"What would be the point of living if we didn't let life change us?" he said, reaching up to tuck a fallen strand of hair behind her ear so that he could see her face. The touch seemed to startle her a bit, and she turned her head up into his hand, feeling the warmth of it against her cheek.

They both jumped at the sound of the telephone ringing. Blinking out of their shared reverie, Charles looked about, searching for the phone. After a moment, his cell phone began to vibrant in his pocket, then his pager. From the bedroom, Elsie's cell phone bleeped, joining the now resounding chorus of ringing phones.

"Good God," he said, fumbling with his phone.

"Hello?" Elsie said, plugging one ear as she answered her cell phone.

"Put the telly on,"

"Beryl? What the hell's going on? All the phones are going off, my pager—"

"Turn on the bloody television," Beryl said, "All_ hell's_ breaking loose."

* * *

*Karen Carpenter died of complications from anorexia nervosa at the height of her fame as part of a musical duo with her brother. Karen was an incredible drummer and vocalist and We've Only Just Begun is a great tune!

*Cherish by The Association. One of my favorite songs of all-time and it's on my fic-writing playlist. About time it showed up in this fic.

*This song also has an amazing appearance in one of my favorite films with Juliet Stevenson and a mustached Alan Rickman, "Truly, Madly, Deeply."

* I already told a few people in the fandom this story, but I know this to be true because I got a very deep cut on my breast (don't ask) and it couldn't be sutured, so it just bled and bled profusely for about 48 hours. *shudder*


	26. Hypertensive

**A/N: **Hello loves, this one's a bit short — and there are some explanatory notes at the end that you don't want to miss. Thank you for your reviews, messages here and on tumblr — I love that you love this fic, it keeps me inspired to write even when it means researching at 2 am :P

* * *

The sound of her feet hitting the ground always managed to calm her; it's why Mary made a point to run every day, rain or shine. Certainly for her fitness and health, yes, but even more so for the numbness it afforded her.

When she heard her phone ringing in her headphones —interrupting the thumping baseline of her jogging playlist— she snapped out of a pleasant runner's high and was immediately, insufferably, annoyed.

"What?" she snarled, bringing her headphone microphone close to her mouth as her steps slowed.

"Mary?"

"_Tony_?" she said, catching her breath, "Sorry — I'm out for my run —"

"Sorry to interrupt," Tony said, "But there's been . . .Mary, Alex has done something. I need to talk to you."

"Well, go ahead," Mary said, "What's happened?"

"No," he said firmly, "I need to talk to you _privately_. Somewhere the press won't overhear. You should get home as soon as you can — if anyone sees you—"

"Tony, _wait_—"

"Don't go straight to the hospital — come to my apartment first. We'll talk."

"Not unless you tell me what this is about," Mary said, kicking the dirt up around her impatiently.

"Your father. . .the hospital. . .well, Alex has come forward as a whistleblower — not just on Downton but _our company_. Although, I think the ramifications will be far worse for your family than for me. . .but I need you to know —"

"Stop prevaricating," Mary snapped, "Is this about Anna—?"

"It's beyond that now," Tony said unsteadily, "No one is going to get out of this unharmed."

* * *

Even though Robert would chide her if he knew, Cora poured herself a second cup of coffee and padded into the den to watch the morning news. He _always _insisted she stop consuming any caffeine at all during her pregnancies, but she'd not been the best patient. Nine months without wine was bad enough; but _coffee too_?

She blew gently across the surface of the mug, lowering herself onto the couch and tucking her feet up under her; which was getting more and more difficult with each week that went by.

Reaching for the remote, she unmuted the telly and sipped her coffee.

" _. . .Gillingham and Green Pharmaceuticals released reports today implicating the hospital administration in a series of back-door deals involving the off-label use of prescriptions that Gillingham and Green say had not been approved. Whistleblower Alexander Green claims that several of Downton's staff have retaliated, escalating with a physical attack at the hospital's annual gala several weeks ago. The hospital's administration has yet to make an official comment, and requests for comment were declined." _

"Mum?"

Cora turned quickly, her coffee sloshing onto her lap, scalding her hand as it dribbled down.

She didn't flinch.

"Mum, it's _all over_ the internet," Sybil said, her voice shaking, "Is it true? Did Daddy really do those things?"

"Oh, Sybbie," Cora said, "I don't know. . ."

They stared wordlessly at the television for a moment, the air in the room gone thick, suffocating. Sybil lowered herself down on the couch next to Cora and numbly reached for her hand, which had gone ice cold.

They both jumped when the phone rang. Cora blinked, looking around slowly for it. Sybil hushed her and leaned over the end of the couch, picking it up from the cradle.

"Hello?"

"Sybil, darling, put your mother on."

Inhaling sharply, she turned to Cora, covering the receiver with one hand, "It's grandma."

Cora furrowed her brow, reaching for the phone, "Violet?"

"Robert needs you here," she said — her voice oddly quiet, as though she were speaking somewhere she was afraid of being overheard, "How quickly can you be here? You need to try to beat the press —"

"Can you at least tell me what's going on? We're sitting here watching the news and — none of it makes any sense."

"It's the fault of all that damnable social media," Violet spat, "The rumor mill has never churned quite so quickly as it does these days — people can ruin another's life with the touch of a button. On their _phones_, for chrissake! On line at_ the grocery_ —"

"Violet, I still don't understand what's being said — has Robert done something — illegal?"

She listened to the faint static at the end of the line, heard Violet take a shuddering breath before responding, "Cora, you need to hear his side — you mustn't think less of him —"

"Has he done something—" Cora squeaked, her throat tightening, Violet cut her off.

"You should be here, by his side, when he speaks to the press —"

"About _what_?"

"He'll give a press conference this afternoon — make a statement–"

"_For fuck's sake_!" Cora cried, her voice breaking, "Tell me what's happening!"

"Cora," Violet said quietly, "Robert made a series of bad judgments many years ago, skeletons long buried that are now being dug up in order to throw us off the scent of the man that attacked that nurse—"

"_Anna_," Cora said, "Her _name _is _Anna,_"

"I think it would be better for Downton if you were here — Mary and Edith will be. Sybil should be too, really, the entire family behind him—"

"I won't!" Sybil snapped, having heard the majority of the conversation through the phone.

Cora looked up at her, mouth agape, "Sybil, darling—"

"I won't support him if — if he's done all they've said he's done. I can't be part of that. It's not fair. It's not fair to Anna and —" she stopped short, her face crumpling, "Mum, I'm scared."

"Please, Cora," Violet implored, "Just come to the hospital -"

Feeling her hand begin to shake, Cora licked her lips and let her eyes flutter closed, fighting back a swell of nausea, "Violet. . .I am going to go lie down. I do not feel well at _all, _and Sybil is very upset. If Robert needs me," she exhaled slowly, "— he knows where to find me."

Clicking the phone off and letting the receiver drop from her hand, Cora kept her eyes closed a moment, then bolted from the couch and into the hallway. A few moments later, Sybil heard her retch.

"Mum?" she called out — then felt her cellphone buzzing in her pocket. Taking it out, she glanced at it,

TOM (9:33 am)

Are you okay?

SYBIL (9:34 am)

I don't even fucking know what's happening! But I think my Dad might be guilty of something bad. Poor mum's a wreck. I've got to check on her, I think she just got sick in the hall.

TOM (9:35 am)

Do you need me to come over? Sybil, I'm so sorry about all of this. I wish there was something I could do. . .

SYBIL (9:40 am)

It's like, even heroes fall I guess. . . but none of it makes any sense. Can you report back to me about what everyone at the hospital is saying? I think I've got to stay here with mum. She's in rough shape.

TOM (9:42 am)

Of course. Let me know if you need anything.

SYBIL (9:45 am)

We will. Thank you for being there for us.

TOM (9: 50 am)

I always will be, Syb. No matter what happens.

* * *

"_. . .The hospital's administration has yet to make an official comment, and requests for comment were declined." _

"What the bloody _fuck,_" Beryl breathed, looking up at the telly in the nurses' break room. She'd come in for a sugar for her coffee and stumbled into a heap of tittering nurses, staring up at the television, their eyes wide. Her heart sunk; a tragedy, must have been. Some accident. A terrorist attack. Maybe the Queen was dead.

"Oi! Baxter!" she said, pushing her way through the hive of nurses, "What the hell—"

Phyllis hushed her, staring, mouth agape, at the television. Beryl listened a moment, unable to believe what she was hearing.

" _. . .Whistleblower, Alexander Green, has implicated Dean of Medicine Robert Crawley in over a decades worth of deals with Gillingham and Green Pharmaceuticals regarding the off-label use of prescriptions that had not yet received approval. Green claims that Downton Hospital accepted financial incentives, including a multi-million dollar bail-out in 1995 . ."_

"Is it true?" Daisy said, appearing at her side. Beryl turned, her gaze vacant, and put a hand on the girl's shoulder. She wanted to say _no, of course not, _but she hesitated.

"I don't know, love," she said, shaking her head, "I honestly don't fucking know."

* * *

"Dr. Clarkson?" Isobel said, bursting into the exam room. Richard turned from the patient he was seeing, a bit irritated.

"I'm with a patient, Isobel—" but when he saw her face, the way she was white-knuckling the door handle, how her knees seemed to buckle under the weight of whatever it was that was next to come from her mouth, he stood slowly, "What's happened?"

"You'd best step out for a moment," she said quietly.

Excusing himself and following her out into the hall, he reached out and tentatively laid a hand over hers, which were clasped in front of her to keep from shaking.

"I take it you've not read the headlines?"

"No," he said, "I haven't had the time to even check my email let alone —"

"Downton is in terrible,_ terrible_ trouble Richard," she said.

He blinked, his pulse quickening at the sound of his name on her breath, "Good God, what's happened?"

"Do you remember a few years ago, the GlaxoSmithKline* scandal?"

He nodded, "How could I not?"

"Well, Gillingham and Green they've — I don't know that it's _true_, I'm not saying that it is, but the reports are there, and it's traveling fast —"

"Inside deals?"

"I think it's perhaps worse than that," she sighed, "The man who attacked Anna — that Green character — he's come forward as a whistleblower, you see. If — if none of it's true, what he's saying about Downton's involvement, why would he ruin his career in the process? He's outed Mr. Gillingham. He's clearly willing to stop at nothing to take down the hospital. Even if it means sacrificing his own company."

"That's not surprising; those corporations always emerge relatively unharmed. You know that." he sighed, "Is any of it true? Did you ever suspect—"

Isobel started to speak, but thought better of it. Instead she reached up to take off her glasses, rubbing her eyes, "I've got to go see Violet."

"She's already on the war path, I'm sure."

Isobel paused, leaning back against the wall, letting her eyes flutter closed, "That's what I'm afraid of."

* * *

The sound of her apartment door closing as John left echoed in her ears until finally, she had to turn the television set up just to hear the news reporter's voice.

He'd told her to shut it off, have a lie down — but she couldn't. How could she? This was all her fault. She should have just kept her mouth shut. Who was she to think that she could stand up to anyone — let alone a man like Green?

_You believed you had Downton behind you, that's why, _she thought, a bitterness creeping in from some deeply buried, cruel place that she attempted to hide with a sunny disposition.

Why should she reveal how angry she really was? About this — about _everything._ Anger wasn't productive unless it was directed outward, and the only person she felt comfortable turning it on was herself.

She cranked the volume of the television higher, planting herself down on the carpet right in front of the screen.

_Look what you've done, _she whispered, hot tears stinging her face.

Wiping her eyes, she tried to focus on the throng of reporters who were positioned outside the hospital. Seemingly out of nowhere, they swarmed a tall woman who was walking toward the front doors — she had on large sunglasses and a long, black coat. Clearly she was _someone_, otherwise why would the press be shoving their microphones in her face?

"_Dr. Painswick! Dr. Painswick, can we get a statement? Did you know about the—" _

"Shit" Anna said quietly, "Oh, _don't do it_ —"

Rosamund removed her sunglasses, shaking her hair out impetuously, "The only thing I have to say is this:" she said, staring straight into the camera, "Alexander Green is a _liar_ and a _coward_ —"

"_But Dr. Painswick, isn't your niece in a relationship with Tony Gillingham? Does she have ties —" _

"I will **not **comment on the personal lives of any staff member of Downton, family or no," Rosamund snapped, "But _mark my words_, Green will be held accountable for taking what was a vicious, _unprovoked _attack on a young, female nurse at our institution and turning it into a circus for the singular purpose of misdirecting your attentions—"

"_Isn't it true that Anna Smith is emotionally unstable? Have you given her a psychiatric evaluation?" _

Rosamund blanched, "Why would I do that? _Of course_ she's unstable, that man beat her in the walls of this hospital, he attempted to rape her — he'd probably have killed her—"

"_So you admit she's unstable?"_

"I didn't say that—"

"_Dr. Painswick, is it true that before she arrived at Downton Anna Smith spent a month in a psychiatric facility in Northampton?" _

"I don't know—"

"_Doesn't Downton perform background checks on employees?"_

"That would be a question for —"

"_Are you saying that you were unaware of Ms Smith's prior psychiatric history?"_

"_I'm_ not her superior —"

"Rosamund!"

The cameras turned, and Robert Crawley came barreling out the hospital's front doors. The press picked up their wires and microphones and ran for him, but he beat them back, cutting through the crowd and roughly grabbing Rosamund by the arm. Anna watched in horror as they fought their way toward the hospital, her chest burning — without taking her eyes from the screen, she groped for her cell phone. Looking down only long enough to dial, she held her breath until she heard the familiar voice at the other end of the line.

* * *

"Oh God," Elsie breathed, picking up her cell, "It's Anna."

"I think she was set to be discharged today," Charles said, wiping his palms against his trousers, "I hope she's not alone."

"Anna," she paused, listening. After a moment she looked up at Charles, her eyes brimming with tears, "Oh, Anna, I'm so sorry —I'm _sorry._ I know._ I know, dear." _

He could hear bits and pieces of Anna's shrill voice on the other end of the line — and just before it went dead, he heard her yell— _you promised me__!_

Elsie paused a moment before lowering the phone, locking the screen and letting it sit dejectedly in her lap. Her eyes drifted back to the television, furtively blinking away tears.

Charles moved slowly, reaching for the remote control so that he could mute the television. The sudden silence of the room was jarring, and she snapped her head toward him, eyes wide.

"Is she safe?" he asked, his eyebrows arching.

"For now," Elsie said, "Obviously quite shaken. Dr. Bates has gone in — and I really think _we_ ought to as well."

"_You_ need to rest," he said, but she sniffed, interrupting him.

"I'll be fine," she said levelly, "_If I go._ If I'm _there,_ if I can . . .I don't know, I'll sit in my office, even. I'll make you run about and do my bidding," she said, forcing a small smile. He hesitated, sighing heavily, "_Please, _Dr. Carson."

He met her pleading gaze, then looked back at the television, _Downton's Dirty Deal, _splayed across the screen in angry red letters.

"Fine," he said, "But we're going to set you up on the couch in your office — no running about and absolutely _no _talking to the press," he stood up, shaking his head, "I don't like this," he said, "I don't like it _at all,_" he looked down at her, softening a bit, "But I would be a liar if I didn't admit that. . .well, I don't want to walk into a _war zone. . ._ without you at my side."

She gave him another smile, a bit stronger this time, "And I wouldn't want you to."

A quiet moment passed between them, then, he reached down and offered his hand. She took it, pushing herself up off the couch and they stood in her den a moment. She felt something constrict in her chest as she looked at him, his face contorted in deep disappointment and, she thought perhaps, even a little fear.

"Are you okay, Dr. Carson?" she asked, putting a hand on his forearm, he looked down, as if surprised by her touch, and then covered it with his.

"I've just. . .I've had some _shocks _lately when it comes to thinking you know people. . ." he sighed, letting his hand drop from hers, "I've given my_ life _to Downton,"

"I know," she said solemnly, "Do you think it's true? How could this have been going on — all the years and _we _didn't know. . ."

He huffed, "And if we _had_ known? Could we have stopped it?" he ran his hands over his face, speaking from behind them, his voice muffled, "Have we unwittingly been a_ part _of it?"

Elsie sighed, "I don't know," she whispered, "I suppose we can only hope _not_."

Peeking out from behind his hands, he gave her an exasperated look, "If I'd known, I'd've put a stop to it," he said, "And if I _couldn't s_top it, I would have_ left. _I know that's probably hard to believe. That I'd put _anything_ ahead of it, of my _work_ but —" he sighed, letting his gaze fall from hers, "It doesn't matter to say it now. It doesn't _change_ anything."

He looked up when he felt her hand on his arm and realized she'd not lifted it since she placed it there.

As she spoke, she gave it a light, reassuring squeeze, "Well," she said softly, "It changes _you_ from where I'm looking."

* * *

* So, this whole suit between Downton and G&amp;G might be vaguely familiar to the GlaxoSmithKline scandal: that suit ended with the largest settlement **ever **of a pharmaceutical company — $3 bil. They had, rather systematically over the course of like a decade, peddled their antidepressant PAXIL for off-label use, and, for use in teens and children — which they were not approved for. In fact, they had research that proved the use of the antidepressant in young adults was linked to an increase in suicides — but they essentially **hid / suppressed **that research and continued to market the drug anyway, even though they knew that it wasn't safe. GSK is still one of the major pharmaceutical companies in the UK and is, in fact, one of the largest and most prominent in the world, despite being implicated in this suit — which kind of goes to show that pharmaceutical companies can get away with **a lot **and emerge unscathed, but the hospitals are typically not so lucky.


	27. Hypotensive

**A/N: Omg, don't get used to 2 chapters in a single weekend! Hahaha. It's the two-part season finale! Indeed, next chapter will see a minor time jump but none of this 1 Year Later shit that _Grey's Anatomy_ pulled. . . **

* * *

"Go round back," Elsie said from behind her thumbnail — which she had been gnawing on since they'd left her apartment. It had, perhaps, been silly to think they'd be able to go in the physician's entrance — it was lined with reporters, photographers and policemen.

"Around back?" Charles said, throwing the car into reverse and attempting to navigate his way out of the overflowing parking lot.

"We can go in through the morgue," she said, pulling her hand from her mouth. Charles took a rather sharp corner and she winced slightly, reaching for the door handle.

"Sorry," he said quietly, reaching a hand over and placing it on her upper thigh. She inhaled as her leg tensed beneath him. He lifted his hand self-consciously, clearing his throat.

"It's alright," she whispered, her mouth gone dry, "Here — park there. We'll sneak in."

The car shuddered to a stop and as Charles pulled the key from the ignition, he turned toward her slightly, his hand hovering on the door handle, "Are you fine to — ?do you need me to come round and —?"

"I'm fine," Elsie said quickly, "But — maybe if you could—I can't reach my—"

He followed her gaze to the buckle of her seatbelt, "Oh — of course," he said, reaching down to click it, his fingers grazing her waist. She huffed out a fast breath, trying to hide the laugh that had bubbled up in her at response to his inadvertent tickling of her side.

As they crossed the parking lot, she noticed that he had slowed his steps to keep pace with her, looking at her out of the corner of his eye.

"I'm _fine_, Dr. Carson," she said, "There are more important things to worry about."

She turned her head up to give him a little smile, and he looked down, his eyes soft.

"I could challenge that assumption if my mind wasn't racing — I feel like I'm about to sneak out of my dormitory, a schoolboy's mischief," Charles said as they crept into the long, darkened hallway of the morgue, "Up to some mild act of mayhem."

_"You?_ Hardly," Elsie whispered, "I'll bet you were head boy?"*

"Is it that obvious?"

"_Painfully_ so," Elsie said, reaching for the door — she gripped it, then pulled her hand back, crying out.

"No, _don't_ —" Charles said, "Let me,"

Pulling the door open, he let her through first. No sooner had they stepped into the hospital's main thoroughfare than they were jointly thrust into the chaos they had so painstakingly tried to avoid.

"Let's just go to your office," Charles said, his hand on the small of her back, leading her down the hall, staying close to the side. He tried not to rush her, but people bustled around them and he was afraid she'd be knocked over or jostled.

As they arrived in pedes, Beryl looked up from the nurse's station, calling across the unit to them, "What in bloody hell are _you_ doing here?" she said, bumbling down the hall toward them, "You've literally walked straight into the fire's of hell."

"She's not going to get involved in _any_ of it — but she refused to stay home and rest," Charles said, "I'm going to settle her into her office and then I need you to debrief me on. . .the situation."

"More like_ perdition_," Beryl said, turning to Elsie, "If you leave that office your ass will be grass and I've got the trimmer."

Δ

* * *

"What are you going to _do_?" Mary said, her untouched cup of tea gone cold as she sat at Tony's kitchen bar — she'd tried never to let him see just how much she marveled (and perhaps,_ envied_) his flat. Modern, spacious — filled with expensive linens and furniture. Far beyond her reach, as it were, but the trappings of a young, ambitious pharmaceutical rep.

"I'm not worried about myself, or the company for that matter," Tony said, "_We've_ got it easy, a few billion socked away in settlement money. . ."

"_Bully for you_," Mary said, giving him a look, "That's why he did it, isn't it? He knew this was all it would take to discredit Downton — and everyone there."

"I suspect so," Tony said, "Though I've known him quite some time and I'd not've thought he had it in him..."

Mary sighed, "But he's got proof — something my father _signed_ or —"

Tony nodded, "It's all there, Mary. He'd be foolish to deny it."

"Why did he need the money in the first place? It's been my understanding that my mother's_ inheritance_ was what kept Downton from financial ruin . . ."

"Well, it did — for a time," Tony said, "But he invested poorly. Lost it and – well, then he came to us."

"_He_ came to _you_?"

"More or less," Tony sighed, "It was . . .well, we were trialing some new drugs, hoping to get buy-in on some potential off-label use and. . .the timing was right."

"I suppose he thought he could get away with it."

"He did, didn't he?" Tony said, arching an eyebrow, "If it hadn't been for Alex, it'd've _never_ gotten out."

Mary lowered her gaze, her shoulders squaring. When she lifted her eyes to him, they were almost black in intensity, her mouth a tight line.

"What can _I_ do?" she asked, folding her hands on the table, "What's the best thing for _me_ to do now?"

Tony shrugged, "You should go support your family — your father will have to talk to the press and I'm sure they're already set to eat him alive," he cleared his throat, then leaned across the table to look at her more purposefully, "Mary, you need to tread _very_ lightly here. Support him, yes, but make no comments. The press will come after you now — especially if they've gotten wind that w_e've_ been–"

"I'll defend myself, and the honor of my family Tony," Mary said, her gaze unwavering.

"You don't know what they'll do to you, Mary." Tony said, reaching across the table to take her hand. She pulled away, sitting back in her chair and folding her arms.

"No — but— I know what _I'm_ capable of."

Δ

* * *

"You aren't to deviate from this statement _at all,_ Robert. Do you understand?" Violet said, pushing a typed speech across his desk.

"I don't want to say _anything_ until I've spoken to Cora," he said, "It's bad enough she's heard about it from the telly — why isn't she here?"

"The last time I called, Sybil said she'd gone up to bed," Isobel said, holding up her cell phone as proof, "I can try back."

"Tell Sybil they _both_ need to be here as soon as possible," Violet said, turning her attention back to Robert, "This is what I've said all along about Cora, she hasn't got the right _disposition_ to be a doctor's wife —"

"Violet," Isobel said gently, "She's pregnant — I'm sure she's exhausted, can't you cut her a little slack?"

"No,_ I can't,_" Violet said, "You know how I feel about this _ridiculous_ pregnancy business. . ."

Robert grimaced, "Mum, _please,_"

"She's your _wife_, she should_ be here_," she looked over her shoulder at Isobel, "Call again and tell Sybil that if Cora's ill, we'll just give her a bin to be sick in — we are in a bloody _hospital_ after all."

Δ

* * *

"Mum, Mrs. Crawley's calling again," Sybil said, glancing at her cell phone, which she'd flung across her mother's bed after the _last time _Isobel had called.

Cora moaned, but didn't lift her head from the pillow.

"Mum maybe we_ should_ go in, for_ you,_ to make sure _you're_ okay. You're probably dehydrated," she said, putting her hand on her mother's forehead, "You're not running a temp but you're clammy — and you've been sick constantly for the last hour. . ."

"I'm_ fine,_ Sybil, it's just the shock of it," Cora said, reaching up to take her hand, "Answer it,"

Reaching for the phone, Sybil shook her head, "Hi Isobel."

"Hi again sweetheart, I'm sorry to keep calling but Violet's_ insisting_ . . .they really need you two to be here. I don't know if you fully grasp what's happened —"

"I don't," Sybil said firmly, "And I don't _care_ — mum's in bad shape and I don't want to leave her and_ don't _want to stuff her into the car and drive over there and put her through hell."

"Should I come by?" Isobel said, "Do you think something's wrong with the baby?"

Sybil hadn't considered that, but suddenly she grew grave with worry, "I don't know," she said quietly, "Would you mind? Coming over? Can you leave?"

Isobel gave a small, rueful laugh, "Sweetie, I'm _desperate_ to."

Δ

* * *

"Robert is going to give a statement," Charles said, handing Elsie a paper cup of tea, "I'm going to go — I think most _everyone_ is, really – so just stay here and I'll come back and let you know what's been said."

She accepted the tea from him, "Thank you, Dr. Carson."

"Don't go sneaking off," he said, heading for the door, "Remember, you're _still_ my patient."

"I know," she smirked, sipping her tea, "I'll be good."

She gave him a few moments to lumber down the hall and out of pedes before she set her cup down and pushed herself up off the couch. She wasn't in her work clothes, hadn't even _showered_, so she certainly wasn't going to go gallivanting around the hospital drawing attention to herself, but no matter her soreness, she wasn't content to sit around doing _nothing._

Peeking around the corner, eyeing the nurse's station, she was reassured that everyone had more or less dispersed, leaving her free to roam about. Logging in to one of the mobile units in the hall, she typed a name into the search bar and hit enter.

"_Oh shit,_" she said under her breath.

Stephanie had already been discharged.

Closing out the computer screen, she limped down the rest of the hall, pausing to look up at the patient board — a few new admits had come in during her surgery, but of course she'd not yet had time to look at their charts —

"Dr Hughes!"

She startled, her hand flying to her breast, which had begun to ache. When she turned, she was surprised to see Stephanie coming down the hall.

"I was just in your chart," Elsie said, taking a heavy step toward her, "It said you'd gone home."

"I did, or, I started to, or, well, _I am_ —" Stephanie said, "But we were sitting in the lot behind all those police cars and reporters and I saw you and Dr. Carson pull in and I had to run back in and find you,"

Elsie smiled, "I hope, for your sake, you didn't actually _run_ —"

"More of an awkward gallop," Stephanie said, reaching into the satchel she had slung over her shoulder. She lifted out what appeared to be a leather bound journal, "— but that has nothing to do with the surgery, I'm just awkward in general—"

"Now, now, I doubt _that_," Elsie said, her voice soft, "Stephanie— I'm _very_ sorry about Samantha."

Stephanie looked up, "I know," she said, "That's why I had to come back and find you," she flipped open the book, "Sam's parents gave me this. I guess she was keeping a diary while she was here. She wrote about _everything_, every day, sometimes a couple of entries in a_ single_ day," finding the slip of paper she was looking for, she pulled the looseleaf out and unfolded it, handing it to Elsie, "I was reading it and . . . well, you should have this."*

Elsie took the paper from her uncertainly, "Did you tear it out?"

"Yeah. I felt guilty for about_ five seconds_ but — she would have wanted me to. I would have felt way worse if I'd left here and never given it to you." She sighed, tucking the journal back into the knapsack, "Dr. Hughes, thank you for everything that you did for me and for Sam. I wish. . _.of course_ I wish that she'd, you know, gotten_ better_ but. . .I'd rather have known her a little than never known her at all. You got that, you know? You just. . .you're a great doctor and. . ." her voice faded, and she reached up to wipe her eyes, "I'm sorry, I promised that I wouldn't cry. . ."

"Come here," Elsie said, taking the girl into her arms, "You're welcome — but really, I think I should be thanking _you._"

Stephanie pulled back, "Thank you for the hug but — did I hurt your — _you know?_"

"I'm going to hurt for a while," Elsie said, patting Stephanie's head affectionately, "And a hug from a grateful patient is a good salve."

"I should go," Stephanie said, "But read that, okay? You promise?"

Elsie nodded, "I will. I'll do it right now."

Stephanie smiled, turning to leave, "It wasn't your fault," she said, "Sam . . . I hope you don't think that I blame you. Or that _she_ did."

Elsie blinked, "Thank you for that."

Stephanie shrugged, "You're a damn good doctor. And so is your boyfriend."

"Oh," Elsie said, her eyebrows raising sharply, "He's _not_ —"

"_Whatever,_" Stephanie said, raising her hands in surrender, "You know what comes after PG13 booby?"

Elsie shook her head.

"Read Sam's note," Stephanie nodded, then, she turned and headed off down the hallway.

Δ

* * *

"Those_ fuckers_," Rosamund sneered, pacing back and forth in her office as Edith attempted to herd her back to her desk.

"That's what they_ do,_" she said, "They try to twist your words,"

"Do you know anything about Anna? Before she came here?"

Edith shook her head, "No — who hired her?"

"Pedes," Rosamund said, "But Elsie Hughes isn't an _idiot_ — she'd've done her homework."

"Maybe it was something Anna went to lengths to cover up. . ."

"There's no shame in treatment," Rosamund said.

"But they might've held it against her anyway," Edith said, "I think we know better than anyone how _intolerant_ people can be."

Rosamund sighed, "Everything is so remarkably fucked up, Edith," she said, lowering herself into a nearby chair, "I'm so sorry you have to go through this."

Edith sat down slowly, "Why did dad do it? He must have known it was _wrong_."

"Oh, darling, _knowing_ something is wrong doesn't keep people from _doing it._"

They exchanged a knowing glance, then Rosamund lowered her face into her hands. Edith rose, going to her side and placing a hand on her shoulder.

"What happens now?"

Rosamund looked up, her face tear stained, "Oh, darling — nothing that's within our control."

Δ

* * *

". . ._lately I've had a strange sense of peace. I don't know if it's just because I'm so sick and exhausted, or if it means something big is about to happen — but I'm much less anxious now._

_It's odd, but, I think this hospitalization was the best thing that could have happened to me. Meeting Steph, getting to interact with so many kind people — I feel . . .I don't know, really looked after and cared about. I guess maybe that's the whole point of a hospital, but still._

_Something terrible happened to that nice nurse I wrote about – Anna? She's got the anesthesiologist boyfriend. I haven't seen him much, but she gets all adorably flushed whenever she talks about him when she comes to take my vitals. I haven't seen her in a long time, and whenever I ask where she is, the other nurses get all sad. _

_Dr. Hughes and Dr. Carson stopped by today. Stephanie said, apparently, there isn't anything between them but I think that's complete and utter bullshit. I've been thinking that, if I'm really sick and. . .well, if I don't get to grow up anymore than I already am, the one thing I'd really regret is not living long enough for someone to look at me the way Dr. Carson looks at Dr. Hughes. I've never seen anything like it — except in the movies, maybe. My parents don't look at each other like that and I'm not sure they ever did. _

_I'm not even sure if Dr. Hughes sees it, but even today when she was talking to me, Dr. Carson was looking at her the whole time. I can't describe it . . .but I'll try. It was this reverence, kind of. You know how in the movies, they always show men looking at women like they want them? But like, as though they are these tiny, delicate, breakable things that they should pick up and possess? That's not how he looks at her at all. He looks at her like he's drawing strength from her, like she's the most constant thing in his life. His sun and moon, maybe. Maybe that's grossly cliched, but gimme a break. I've been in this damn hospital forever. _

_I get the feeling I won't be much longer though. I was making that list a few days ago, but now I don't really care about it. I feel like whatever happens to me, I've done a little good here and maybe that's all I'll ever do. But isn't it better to do some than none at all? _

_I only wish I had time to tell the world all the things that I've seen it do — sometimes being quiet means that you see all these things other people don't, like how poor Dr. Carson's hand twitches as he thinks about putting it on Dr. Hughes' lower back when they leave the room._

_I wonder what would happen if he did? Would she reject him? What is he so afraid of? _

_Or maybe, what is she so afraid of? You know, I don't think she's ever even left this hospital since I've been here. Sometimes she wears the same jewelry two or three days in a row, so I bet she sleeps here. Maybe she doesn't want to go home. I can understand that. But I don't want to go home because of what's there._

_Maybe she doesn't want to go home because of what isn't there. _

Elsie turned the paper over, a ripple of disappointment moving through her as she realized that was where the entry ended. She had almost been able to hear the girl's bright voice reading the words — and she _had_ heard them. She folded the paper up, tucking it into her jeans pocket. Looking around her office, stacks of paper everywhere, discarded coffee cups and the same, somewhat banal furniture she'd had for decades, she wondered how a person so young had seen her so clearly? More clearly than she could see herself?

She remembered in medical school, the first time she'd held a human brain in her hands. The cadaver lab was weeks long, and she'd been eager to cut — but the moment that had stopped her in her tracks was the slight hermetic_ pop _of the skull, the whir of the bone saw, as she exposed the tissue of the brain.*

The patient — or cadaver, she supposed — had been an old man. Or, old to _her_ at the time. Thinking back on it, he wasn't _that_ old really — no older than she herself was now._ Or Dr. Carson_. She had been stricken by how all of his memories, his entire personhood, _his very existence,_ was encapsulated in a few pounds of flesh.

It struck her as odd that the older one got, the more they knew — and the more they_ knew,_ the less could could _remember._ Whereas the young, when they died, didn't live_ long enough_ to know — to be able to _forget._

_Perhaps that's why,_ she thought; while she had spent so many years trying to _remember _what it felt like to be loved, she'd never figured out at what point she'd managed to _forget. _

Δ

* * *

"Anna,_ calm down_ — I'm on my way home now, I promise, it's just there's so much bloody traffic and—"

"I have to tell you," Anna cried. She'd curled up in her bed, hair still dripping wet from the shower she'd taken in a feeble attempt to calm herself down. She shook with a chill, her pillow damp against her face, "John, you've got know the truth before the papers start saying it,"

"Wait till I come home, love," he said, "_Please_—"

"No, they'll probably put it on the radio —" she wailed, "John, _please_, just _listen_."

"I'm listening," he said, gripping the steering wheel as traffic slowed to a crawl.

Anna sighed, "When — when I was a teenager — I — my step-father he," she paused, her voice breaking as she cried, "He _raped_ me, beat up _my sister_ and . . .well, one night I waited. I waited for him to come into our room and —"

John listened, watching the car tail lights in front of him glow red, "Darling?"

"I waited for him and . . .I'd taken a knife from the kitchen. . ." she inhaled quickly, speaking so fast he could hardly understand her, "I stabbed him, in the leg — he didn't _die,_ but I hurt him and— and I left. I left and I never went back but — but before I came to Downton, before I finished nursing school, I was — I — _I tried to_ —"

"Oh darling," John whispered, leaning forward over the steering wheel, "Anna, I'm so sorry."

"They put me in one of those places, you know? A hospital. In Northampton."

"But that's not a _bad_ thing," John said, "You needed help and you got it —"

"They'll try to use it now, though," Anna said, "They'll try to say I'm . ._ crazy or depressed_ or . . if they find out why I was there, what I'd done to my step-dad."

John's stomach flopped over, "Oh Christ,"

"They'll think Green's telling the truth, that_ I_ attacked _him_ — that I'm —"

"Anna, they —"

"No one else must ever know," she said, "What am I going to do?"

The car behind him honked loudly and he started, traffic finally having begun to move forward, "I'm almost home, Anna, we'll figure it out. I promise we'll figure it out."

Δ

* * *

"He's put it off," Charles said, bursting into Elsie's office. She quickly reached up to wipe her tears, struggling to sit up on the couch.

"What?"

"The press conference – Isobel's gone to look in on Cora. I think she's unwell."

"I would imagine _so_," Elsie said quietly, "What a shock she's had."

"And, well, given her condition. . ."

Elsie's eyes widened, "Oh, Lord, you're right. . .poor lass."

Charles looked at her quizzically, "You look flushed. Are you alright?" he pulled her rolling office chair from behind her desk and positioned it next to the couch she was laying on.

She shrugged, "Are any of us?"

He nodded, "I heard something in the hall that concerned me. I'm sure it's merely a rumor, but it seems to be one that's picking up speed."

"Oh?"

He shifted uncomfortably in his chair, "It seems that the news reporters are saying that Anna was in a facility — _a mental hospital_ – before she came to Downton."

Elsie blinked, her pulse quickening, "Oh?"

He furrowed his brow, "But the hospital would have known about it. If it were true."

She swallowed, "I . . . I suppose perhaps it could have. . ._been overlooked_ . . .if it was a long time ago. While she was still in school."

"I doubt it," Charles said, "Those things tend to linger."

Elsie didn't speak for a moment, but between the agonizing pain in her chest from where her incisions were throbbing, and the continuous sick feeling in her stomach, she finally gave in to the anguish that had been squeezing her heart.

"_God, no, no, no,_" she whispered, her shoulders shaking.

"What—?"

"Dr. Carson I . . ._I'm sorry,_ I'm just . . ."

"I should take you home," he said standing, "It was wrong to bring you here."

"No, Dr. Carson, _please,_ wait a moment," she pulled the folded up slip of paper from her pocket and handed it to him. He kept his eyes on her as he unfolded it.

For a minute, as he read, the only sound in her office was that of her own sniffling and his fingers nervously stroking the paper. When he'd finished reading, he lowered himself back down into the chair, letting the note gently drift into his lap.

"Stephanie she — before she left — she ripped it out of the journal Samantha had been keeping. She gave it to me."

Charles nodded, his hand shaking as he reached down to hand it back to her. She took it, folding it deliberately before stuffing it back into her pocket.

"She was a bright girl," he murmured, refusing to look her in the eye, "Quite a way with words."

Elsie smiled a bit, reaching a finger up to clear the tears from her eyes, "_Insightful_."

He blinked, raising his eyes to hers, "Yes? You think so?"

She exhaled, her eyes kind, "I do, Dr. Carson."

He hesitated, biting his lip a moment, "I suppose it's times like these, amidst the pandemonium, when I recognize it. . ."

"Recognize what?" she asked, her voice practically a hush.

He swallowed, turning his tremoring hands over, "That you . . . are my still point in a turning world." *

* * *

* Haha, yeah, remember that interview when he was like "I was head boy" and PL was like, "I wasn't even a prefect!" Let's make that modern AU canon.

* Props to Sam (royaltydowntonandlife) who actually came up with this idea!

* I once spent about ten hours in a morgue, doing my requisite autopsy observation, and really that's about the only sound I can think of to describe when you . . .idk, sort of pop the top of the skull off. It's like when you hit the bottom of a jar with your elbow to break the hermetic seal so you can twist the cap off. . .yeah. Most of Elsie's feels came, sort of, directly from my feels at witnessing that for the first time. It was pretty life-alterting, tbh.

* I know I used this line in another fic but it was always meant for this fic, I swear!

Δ


	28. Malpractice

**A/N: Y'all made me rethink the time jump that I had originally planned — plus, I shuffled a few plot-things around so I actually needed a filler chapter anyhow. But guess what?! That works out really well for those of you who were angsting over what Elsie's response to be to Charles' truth bomb in the last chapter *and* we're going to make some headway in the Cobert plot — still in angstville, I'm afraid.**

* * *

_He hesitated, biting his lip a moment, "I suppose it's times like these, pandemonium, when I recognize it the most. . ." _

"_Recognize what?" she asked, her voice practically a hush. _

_He swallowed, turning his hands over as they tremored, "That you . . . are my still point in a turning world." _

He couldn't look at her; closed his eyes, in fact. Too afraid of what he _wouldn't _see flicker across her face.

_You old fool, _he silently chided, _how could you say something so maudlin? _An apologetic laugh welled up in him and he was about to lift his gaze, shrug it off, proclaim how exhausted he was; when he felt her warm little hand on his forearm.

"Oh, _Dr. Carson_," she sighed, drumming her fingers lightly on his skin. He did look up then, meeting her eyes — which still glimmered, threatening tears. She let her hand glide over his wrist, curling her fingers around his hand and giving it a squeeze.

Glancing down at where their hands were joined, he cleared his throat, "What I meant was—the world spinning madly on and all, you make me feel a bit —_steady._"

Ducking her head down a bit so that she could find his gaze, she whispered, "You can always hold my hand if you need to feel steady. . ."

When he didn't immediately raise his eyes to hers, she reached her free hand up and gently placed it on his cheek, her fingers twitching uncertainly at the sensation of his stubble against her palm.

When he lifted his chin, looking at her straight on, he saw a light in her eyes — a beacon in a dark harbor — and he couldn't help but smile; hope washing over him like a raging sea that had finally begun to calm.

Δ*

Isobel lifted the whistling kettle from the stove and turned to Sybil, nodding toward the tray she'd laid out on the sideboard, "Could you put a few biscuits on there, love?" she said, pouring water into the waiting teapot.

Sybil nodded, "I will —but I doubt she'll eat them."

Isobel laughed, returning the kettle to the stove top and wiping her hands on her slacks, "They're for _us,_ sweetie." she said, nipping a biscuit from the plate and popping it between her teeth before she lifted the tea tray into her arms.

"Your father mentioned you're interested in nursing," Isobel mumbled through the biscuit as they climbed the stairs to the bedroom—where Cora was, hopefully, still napping.

"Mhm, rather than being a doctor," Sybil said, eyeing Isobel as she mounted the stairs, precariously packed tea tray shaking slightly as she took step after step, "I feel like doctors don't see patients _nearly_ so much as nurses do."

"I'd tend to agree," Isobel said, the biscuit bobbing precariously on her lip. She paused in front of Cora's bedroom door, "Would you give the door a push for me?"

Sybil nodded, hurrying to her side and nudging the door open, "When everything's settled down, if it _ever_ is, can I come shadow you? In Dr. Clarkson's office?"

Isobel's eyes sparkled, "Of course," she mumbled, "But wouldn't you rather go somewhere more . . .exciting?"

"I just want to learn from the best," Sybil said, biting her lip instinctively as she watched one end of the biscuit drop from Isobel's mouth onto the tray and into an empty tea cup. Blushing, Isobel chewed the bit left in her mouth and gave Sybil a small shrug as she tiptoed into the room.

"That cup'll be _mine,_ then!" she said, turning from Sybil to look for a place to lower the tea tray.

"Here let me —" Sybil said, holding her arms out. Isobel nodded, handing it to her with great care, and then settling in at the foot of Cora's bed. Without waking her, she rested her fingers lightly on her wrist, feeling her pulse.

"She's still a little tachycardic—" Isobel sighed, looking up at Sybil, who had joined her at the foot of the bed, nibbling on a chocolate biscuit she'd purloined from the tea tray.

"Dehydration?" Sybil asked as she chewed, "She's been vomiting . . ."

"Very good _Nurse Sybil,_" Isobel said, "I think that's the likely cause but — well, I'm not sure that I'd feel confident saying this is _only_ the result of experiencing a shock." She furrowed her brow, resting her hand gently on Cora's belly, "How many along weeks is she?"

Sybil thought a moment, "She's due for her next ultrasound soon, uh, about eighteen weeks I think?"

"_Hmm,_" Isobel said, running her hands the length of Cora's belly, "Her measurements seem a bit off — by _feel_, anyway— I couldn't be sure without the _means_ to measure _properly_ but. . .well, if we could get her into the office. . ."

"You don't think something's wrong with the baby?" Sybil said quietly, folding her arms tightly across her chest, "And it's making her ill?"

Isobel sighed wearily and began to respond, but Cora stirred, her eyes fluttering open.

"Isobel?" she asked hoarsely, "What are you doing —" she grimaced, "Oh, good_ Lord _I feel_ horrible—_"

"I know, dear," Isobel said, looking up at Sybil uneasily, "I . . .I think perhaps we need to pack you up and drive to the hospital. You're quite dehydrated."

"Where's Robert?"

"He's still there," Sybil piped up, "I think he's getting ready to talk to the press."

"By the time we got you settled into a room I'm sure he'll be right by your side," Isobel said gently, though she wasn't sure if she was making a promise not easily kept.

Cora groaned, "Is the baby okay?"

"That's what we want to be sure of," Isobel said, petting Cora's belly gently. She turned her face up to Sybil, "Darling, why don't you put together an overnight bag, just in case, and I'll help her downstairs."

Δ

"Dr. Crawley!"

Mary turned, furrowing her brow as Matthew jogged the length of the corridor to catch up with her.

"Where is your _better half?_" Mary asked curtly, giving a small flip of her hair.

Matthew blinked, then blushed slightly, "Lavinia's home with a stomach thing—" he sighed, "I must admit, I wish that _I _was. I imagine you do as well."

Mary huffed, "I wouldn't be anywhere else. Downton is my life." she said simply, turning on her heels to continue on down the hall toward her father's office.

"Mary—_wait_."

She stopped, turning sharply back to him at the sound of her name.

"I just wanted to say that — I'm terribly sorry about this all. I imagine this must be a very difficult time for you and. . .well, I suppose I'm only sorry that we've gotten off on the wrong foot. So it would seem."

"I've not been particularly accommodating," Mary said quietly, "When we're all on the other side of . . . all _this_ . . .perhaps we can make another attempt."

Matthew offered her a small smile, "Cardiothoracic surgery training doesn't quite prepare you for _these_ kinds of matters of the heart, do they?"

Mary let her gaze fall to the floor, turning away from him slowly, "Haven't you heard? she whispered, "I don't _have_ a heart."

"How do you figure that?" Matthew asked, quickening his steps once again to keep up with her. She turned her head, regarding him and his persistence.

"Medicine as a field of study. . .surgery. . .I've spent _far_ too long in the land of the dead."

Δ

"_. . .Dean of Medicine Robert Crawley gave a brief statement to the press this afternoon, saying that the hospital is undergoing an internal review to assess the validity of Green's claims. They are expecting to undergo an additional external review by the middle of next week. He did not confirm or deny the allegations and refused to take questions from the press at this time. The hospital has declined repeated interview requests. We will update on this story as more information becomes available." _

"The press is getting restless," Rosamund said, digging through her purse for a cigarette. Robert didn't even chide her, he hardly noticed. Looking over the edge of the hospital's roof, he could see the blockades down below, the local police force trying to control the ever-growing crowd of reporters.

"I tried to get out, to go home — look in on Cora," he said, "But I can't even get out the door. It looks like traffic's blocked off the perimeter of Yorkshire."

Rosamund nodded, popping the cigarette between her teeth, "Bobby, I just want you to know that I _do_ understand why you did it."

"You do?"

She nodded, inhaling deeply as she flicked her lighter, "I still think it was a completely _idiotic_ thing to do, but I know you thought at the time —"

Robert shook his head, "I never _thought_ it was the right thing to do, I _knew _it was wrong but I didn't feel as though I had a choice."

"Why didn't you come to me? To mum?"

He threw her a look, "Ros, would _you _have gone to mum?"

Rosamund scoffed, "Not even for a hangnail."

"Right, well, I didn't want to trouble you with it. It was right around when you and Duke got married."

"Was it?" Rosamund said, coughing slightly, "You were keeping that secret for a _long _time, then."

Robert nodded, "I wanted to come to you, you know. After Duke died and — the whole thing with John Gillingham. . .I wanted to tell you that I. . .that I knew you were still a good person."

"Hm," Rosamund huffed, "Sounds like you were trying to absolve yourself of a rather _large_ sin in the process."

"I suppose maybe I was," Robert said sheepishly.

Finishing her cigarette, Rosamund lifted her high-heeled foot and stubbed it out on the bottom, tucking it into her skirt pocket.

"Not going to pitch it over the edge at all our admirers?" Robert asked, nodding toward the edge of the roof.

"No," Rosamund sighed, pulling a stick of gum out of her purse, "They'd probably keep it to get my DNA off later."

Δ

"Beryl will bring your car round tomorrow," Charles said, putting his car in park outside Elsie's flat, "Though I would caution you against driving a few more days at least. If you're certain you need to go in, a few hours here or there for the remainder of the week, let me know and I'll be your _chauffeur._"

Elsie cleared her throat, "Are you . . . going back to yours, then?"

He blinked, his lips parting uncertainly, "I was. . .I don't _have_ to. I don't _want_—" he held her gaze a moment, trying to figure out what her body was saying, "I don't want to leave if . . .if you're not ready to be on your own."

Biting her lip, Elsie turned toward the window, hiding her face from him, "In light of today's agony I think . . .I'd prefer if you stayed. At least for a little while."

Charles sighed, removing his keys from the ignition, "Then I shall," he pushed his door open and she waited, knowing he'd come round to open hers. He gave her his hand and helped her out — she'd run around far too much and now she ached all over. She gave him a half-smile as they headed toward the front stoop of her flat.

She took the first few steps before she noticed that he'd hung back, eyeing her hesitantly.

She reached out and gripped the rail, letting her body lean against it, letting out a half-exhausted-laugh, half-exasperated-sigh, "C'mon then, Dr. Carson — what are you afraid of?"

He shook his head, his hands tensing at his sides, "I feel . . .a _shaking_ of the ground I stand on, like everything I believe is going to be tested. . ." he said quietly. Then, almost as quickly as he'd uttered it, he blinked to attention, shrugging his shoulders, "Sorry — I've just — I've suddenly found myself feeling very _wobbly_ about all this."

She didn't say anything, just tipped her head a bit to one side and took a gentle step down — and offered him her hand.

Δ

"Well, I doubt it's anything serious," Dr. Tapsell* said, removing his glasses, "You've probably caught a bug — food poisoning, perhaps."

"But _the baby_," Isobel said, pulling the doctor away from where Cora lay on the emergency room gurney, "You're the on call obstetrician, yes? Don't you think her measurements are a bit off—?"

"I'll thank you not to tell me how to do my job, Isobel," he said sharply, "My understanding this pregnancy was a bit of a shock; she's probably got her dates mixed up as well. Her follow-up ultrasound is next week and they'll have a closer look then. She's hydrated now, the best thing she can do is rest."

Isobel sighed, "Well . . .if you're_ sure_."

"I _am_," Dr. Tapsell frowned, "I'll get her discharge paperwork."

Sybil appeared at her side just as he left the room, "That's it? He's just going to give her a banana bag* and be done with it?"

"I don't like him much," Isobel said, "I think we should ask Dr. Clarkson to pop by, just to look in. . .I'll go call his office."

She squeezed Sybil's shoulder and turned, opening the door — to see Dr. Clarkson standing about rather sheepishly.

"Oh, _Good Lord_," Isobel yelped, "Your ears must have been burning. I was just about to call."

"Well, the emergency room called the office to ask about one of her prescriptions — which was out of date, of course, the damned electronic record* — anyway, since you're not over there holding down the fort I had to answer the phone. When I heard she was here I closed up shop and came over straight away."

Isobel blushed slightly, "Sorry I've skipped out on you today. . ."

"By the looks of it, it was the right decision," he said, going over to Cora's bed. He eyed the ultrasound machine in the corner and gave Isobel a conspiratory glance, "How much shall I wager that Dr. Tapsell didn't even turn that bloody thing on?"

"He didn't!" Sybil cried, plopping down in a corner armchair, "Something's wrong with the baby, I know it. And Isobel does too, don't you?"

"I've got a feeling," Isobel said, "I think the baby is . . .on the small side, perhaps. Sybil said she's eighteen weeks but. . .well, measure her."

Dr. Clarkson paused a moment, his hands hovering over Cora's middle. She slept with the forced peace of exhaustion as he lifted her johnny just enough to expose her belly.

"Isobel, turn on that ultrasound if you would please," he said, "Sybil, hand me that measuring tape there, would you?"

Eager to help, Sybil bounced up, snatching the measuring tape from the counter and unwinding it before she handed it to him. He furrowed his brow, concentrating deeply, as he stretched it over the rise of Cora's middle.

"Well, you're not _wrong,_ Isobel," he said after a moment. He dropped the measuring tape and took the ultrasound wand from Isobel, who dabbed a bit of gel on Cora's belly. Pressing the wand against her pale skin, he looked up at the screen.

No one spoke, and after a moment, the only sound in the room was the baby's heartbeat, a dull echo that made Sybil's throat ache.

"Sybil," he said in a hush, "Would you mind fetching Dr. Tapsell for me?"

She hesitated, but Isobel nodded to her — and she quietly disappeared from the room. Isobel came around to the opposite side of the bed and looked at the ultrasound, chewing her thumbnail nervously.

"What is it, then?" she said, knowing he was about to confirm her suspicion.

"Enlarged echogenic kidneys, occipital encephalocoele and possibly the beginnings of polydactly in the feet. . ." he said, his voice shaking. They both watched the monitor for a moment, and just as the fetus arched its back, Cora began to stir awake.

"What does it imply, Dr. Clarkson? Isobel whispered, leaning down close to his face so he could speak in hushed tones.

"I'm going to ask Dr. Tapsell to confirm, but I'm almost positive it's Meckel-Gruber Syndrome*. The kidneys. . .it's almost a sure sign."

Isobel blanched, "But Dr. Clarkson. . .if it's that she'd have to. . ."

"Clarkson, what are you doing to my patient?" Tapsell said, crashing into the room, Sybil fumbling in tow.

"Dr. Tapsell, if you would, look at this ultrasound."

"I didn't _order_ an ultrasound," he said resolutely.

"What does _this_ look like," Dr. Clarkson said evenly, pointing to the screen, "Or _this?_ Or what about this, here, at the _kidneys?_ What does _this_ appear to be?"

Dr. Tapsell refused to look, but as Dr. Clarkson's gaze darkened, he cowered a bit, letting his gaze flicker to the monitor.

He stared at it a moment, and then, the color drained from his face.

Then, it flushed bright red.

"Dr. Clarkson, may I see you outside for a moment."

"You _may_," Dr. Clarkson said, handing the ultrasound wand to Isobel. He leaned over, letting his hand settle on her upper arm as he whispered, "Get her cleaned up, but don't say anything until we can get Robert down here."

Isobel nodded, watching as he left the room. Cora blinked up at her sleepily and Sybil, who had said nothing, began to cry.

"Oh, sweetheart," Isobel said, reaching over and pushing the hair from Sybil's face, which only made the girl cry harder, "Oh, _dear girl_. . ."

Δ

_You must be mad,_ Anna thought, pacing about the room, _you've got to be stark raving mad to be doing this—_. She paused, looking about, her eyes darting from one corner to the next. She'd knocked first, expected to have woken her from a nap perhaps. Then she noticed the flat's front door wasn't shut all the way. Worry trembled in her chest and made her push inside, afraid something had happened.

_"Dr. Hughes?"_ she'd called out, stepping lightly into the hall.

She wasn't there, but nothing looked amiss.

Then she noticed the telly was on, still broadcasting the news.

_Of course, _Anna thought, pausing in the hall, _she's gone straight to the hospital. _

She thought then she ought to just turn around and leave. She should have called first anyhow, but she was afraid she'd lose her nerve; lose the strength she'd built up to ask her for help, particularly when she knew she wasn't exactly in a state of being without the need for it herself.

Taking a few more steps down the hall, she peeked around the corner to what she quickly recognized was Dr. Hughes' bedroom. The room was only slightly untidy, though the sheets of the bed were in a heap and — she found it rather curious to note that both pillows were indented where heads had earlier been.

_None of my damn business, _she said, stalling herself. She didn't want to leave, thinking perhaps she'd be back any moment, that if she left and went back home she'd lose her resolve — that maybe, in light of all of this, she'd finally collapse fully into herself and lose everything. That she would not be able to survive it any longer; that she'd hurt John, that Downton would fall around her and she would be to blame for it all.

It was this thought that overtook her as she heard keys turn in the front door.

* * *

* this page-break has now become an inside joke with Steph. Last chapter it was a mistake, now it's a thing. delta triangle

* YEP THAT'S THE DOCTOR THAT KILLED SYBIL BUT NOPE HE'S NOT GONNA KILL CORA HE'S JUST THE RESIDENT IDIOT.

* Just what you call the fluid bolus they give you if you're dehydrated. It's got potassium in it to help replenish yours if you've been throwing up a lot. That's why they call it a "banana bag" haha.

* This will get explained next chapter, but in case anyone Googles it — well, you'll probably find out where this plot line is going based on that alone. It's genetic and if the gene is present, each pregnancy has a 25% chance — so, this is Cora's fourth. . .*sigh*


	29. Quickening

**A/N: **Hi guys! I have to work all weekend — sigh — but the next two chapters are written so maybe you'll even get another one before the end of next week! The next few chapters have trigger warnings regarding miscarriage, abortion discussion, discussion of pregnancy termination, depression, anxiety, post-traumatic stress and I think that's about it for this round. Plot's moving steadily along! Thank you, as always, for being so enthusiastic about this fic. Hoping to continue to give you a new "episode" each week! Oh, notes at the end too. As per usual. I'm glad you guys enjoy those!

* * *

Anna held her breath, pressing herself up against the wall behind the bedroom door. She listened hard, stilling her body so that her acuity of hearing would be — _or at least seem_ — heightened. She heard Dr. Hughes' muffled voice, and then, another deeper voice in response.

Dr. Carson.

"_Go have a lie down — or a bath, perhaps. I'll put tea on." _

Footsteps coming down the hall toward her, then, growing louder until she saw the doorknob turning, the door swinging toward her. Instinctively, her hands shot out to protect her from being trapped by it.

Hearing the sound of hands slapping against the wood, Elsie turned sharply as she closed the door. Anna reached out and covered Elsie's mouth.

"Please," she whispered, "I don't want him to know I'm here."

Elsie's eyes widened and she reached up to lower Anna's hands from her face.

"What _are_ you doing here?" she asked — shocked, but not unkind.

"I—well, I came by and—I _did_ knock. Your door was ajar. I came in, thinking perhaps something was wrong. John mentioned your surgery and I. . .when you weren't here, but the telly was on . . .I figured you'd dragged yourself to the hospital and. . .well, I was going to leave once I'd checked to make sure you weren't just _napping_ but. . .I heard the key in the door and then — _Dr. Carson_—"

Elsie blushed, "He's looking after me," she said slowly, "I'm still quite sore." Wincing, she moved slowly past Anna and crumpled onto her bed, grateful for how passively it received her, "Why don't you want him to know you're here?"

Anna wrung her hands, "Did you see the interview Dr. Painswick gave to the press?"

Elsie shook her head, "I don't think so."

"Well, she. . .she said some things . . .vaguely incriminating. She didn't mean to, obviously she doesn't know anything but . . .now people are talking. I'm afraid they're going to try to dig deeper."

She raised her gaze and looked intensely at Elsie — not wanting to need to say what she was thinking, imploring her to realize what she was on about. After a moment, Elsie's still-slowed brain began to hum to life again — and a realization sickened her.

"Anna, no, they wouldn't be able to find out anything. The hospital would _never _release that information to the press."

"They could subpoena it though. For the investigation," she began to pace, but stopped short when she realized she was making more noise than was preferred.

"They've not reason to."

"But they _do_ — Green's gone to all this trouble to paint the night of the gala as some kind of . . ._retribution_ for whatever trouble Dean Crawley has gotten the hospital into with Gillingham and Green. . ."

"He couldn't have known anything about you, Anna."

"Sure he could have! We don't know about him. Maybe he. . .maybe he knew someone, who was in Northampton when I was. Maybe. . ." she grimaced, her face paling, "Maybe he knows my step-father somehow."

"No, no," Elsie hushed, reaching her arms out to Anna. She hesitated, and didn't accept them — but she did quietly settle herself down on the edge of Elsie's bed, mindful to avert her gaze from the pillows.

"If they find out about what happened—"

"Even if — you have no motive," Elsie scoffed, "You didn't know anything about the deals Downton had with Gillingham and Green — none of us did!"

"I don't know," Anna said, shaking her head sadly, "If he's trying to imply that Downton has some kind of . . .vendetta. . .then wouldn't it make sense to send the least suspecting person off to do the job? I mean. . .not to say I'm an _angel_ but. . .I do try to keep to myself, I keep out of the politics. . .maybe he'd say the Crawley's paid me off or something. . ."

Elsie rested her hand on Anna's knee, "I think you're giving this man _far_ too much credit. I don't think he's some criminal mastermind. . . just a miserable bastard."

"In my experience, Dr. Hughes, men like Green don't have to be halfway intelligent to find ways to avoid being accountable for their crimes. Especially when they have power."

Elsie lowered her gaze, _poor lass, wise beyond her years in the way only suffering affords. _She sighed, her chest stinging. Her day — the last forty-eight hours, really — was finally catching up to her. The doctor within her was irate; how could she be so careless? When she lifted her head and looked to Anna, who had quietly begun to cry in hollow frustration, she felt another ache in her chest that had nothing to do with incisions.

"There's something else, though." Anna said, keeping her eyes on her hands, which she held tightly to her lap, "I've not really told you _why _I was in Northampton."

"I didn't ask," Elsie said quietly, "You're entitled to a degree of privacy beyond what was required when I hired you. You were treated for a depressive episode. No shame in that."

"Yes but — if they find out _why I was sent there, _what _happened—_they'd have reason to think me capable of hurting Mr. Green."

Elsie blinked, "You mean . . .what happened with your step-father? You shared that when you were hired; That you'd left home because he was abusive. Why would that imply you were violent?"

Anna's shoulders began to shake uncontrollably, "Because I didn't just _leave, _I ran. Because. . .one night, when I was a young teenager he— I knew he was going to come into my room, he did it every night — and — and before I went to bed I took a knife from the kitchen drawer and —" her tears choked her, and she brought a hand to her mouth, trying to quiet her sobs.

Elsie stiffened next to her, "Oh God," she said on a halting breath, "Anna did you —?"

She nodded wildly, "I didn't kill him," she squeaked, "I stabbed him — in the _leg_ and —" she shook her head, biting down hard on the side of her hand. Elsie's jaw dropped and she felt her stomach sink equally as fast.

"Anna, I don't know—" Elsie said again, pressing a hand to her chest.

"I need your help," Anna cried, "Or else I wouldn't have told you!"

Pushing herself up from the bed, Anna started for the door — realizing as her hand hovered over it that she couldn't just bolt out — not unless Dr. Carson was gone. Elsie sighed, noticing her hesitation and understanding the reason why. She rose slowly, moving her hand from her chest to her breast to apply counter pressure as she crossed the room to ease the ache. She lifted her other hand and pressed it against Anna's damp cheek, thumbing away a few stray tears.

"I'll tell him to go out to the grocery," she said quietly, "He'll be chuffed to think I've asked him to fetch me some Walkers."

Anna gave her a small smile, but it faded almost as soon as she'd tried, "I'm so sorry, Dr. Hughes. I never meant to bring you into this. Really, I just . . .I didn't know who else to go to. I feel awful, I'm so stupid and — and really this is all my fault—"

Elsie sighed, "Anna, stop. I won't listen to that. Don't be so cruel to yourself."

"We can't let Dr. Carson—"

Elsie hushed her, "Wait here. I'll send him off— by the time he comes back it'll look ilke you just dropped by while he was out. And I'll put a kettle on and find you a jumper to wear—" she turned her hand slightly so that the backs of her fingers gently stroked Anna's cheek, "You're as cold as a _witch's tit." _

Finally, Anna did manage a bit of a smile.

Elsie pressed her palm against the side of her breast and shook her head, "Though not _this _witch's tit, mind you. Bloody thing feels like someone's pushed a hot poker through it."

Anna frowned, "I'll just go — when he's left. You need to rest. I've already riled you up enough as it is. . ."

Elsie waved her hand dismissively, "I won't rest, Anna. Not until we figure out what to do."

"Well, what I should do. . ." Anna said, "_You're_ not responsible for any of this."

"If I'd not sent you, the night of the gala, if I'd not been —"

Anna's head snapped up to look at her straight-on, "Dr. Hughes, don't. Don't even go there. This wasn't your fault at all."

"I can't help but think — that if I'd not sent you. If I'd not had a drink. If I'd —"

"Please don't," Anna said, "I stand the thought that I've caused you pain in this. I've already caused the downfall of the hospital—"

"You're not to blame for that," Elsie said firmly, "That's all Robert Crawley's doing. Don't take that on."

Anna sighed, lowering her chin to her chest, "I want justice, Dr. Hughes — but at what cost?"

"Don't confuse justice with revenge," Elsie said, "Revenge is a cycle; justice is about closure. Whether or not you feel it, you're the one with the power now. What you do next will either continue that cycle — or break it."

"I just want this to end," Anna whispered.

"I know," Elsie said, putting a hand on Anna's shoulder, "And it will. No one should be able to do what he did and get away with it."

Δ

"The physical markers for this genetic abnormality are quite specific*," Dr. Clarkson said, removing his glasses and sliding them into his breast pocket, "The abnormally large, cystic kidneys. The hydrocephalus. Beginnings of polydactyly here, in the feet. We can test . . .for the genetic markers but that's normally done . . . after."

Robert blinked, "After . . .?"

"I've known you both a very long time. Had the privilege of working alongside you. Watching you raise your daughters. . .there is no easy way for me to say this."

"The baby will die," Cora said quietly. She hadn't spoken since she'd woken up during the initial ultrasound.

"If the fetus survives to term, it would die within days. Probably within hours after birth." Dr. Clarkson said, his voice measured, "Given that you are still in the second trimester, you have the option to terminate."

"But. . ." Robert said, swallowing hard, ". . .isn't she too far along?*"

Dr. Clarkson shook his head, "Not at all, actually. It would be a dilation and evacuation. Slightly different from a first term termination. Normally it could even be done as an outpatient procedure but. . .given that Cora is under the weather we could admit her and do the prep. By the time she's rehydrated, she'd be ready for the procedure."

Robert slunk down onto the bed at Cora's feet, resting his hand on her legs beneath the flimsy hospital blankets.

"It's an autosomal recessive condition. Each pregnancy carries a 25 percent chance. And, well, this _is_ your fourth pregnancy. . ." Dr. Clarkson said, hearing his own empty words and letting them trail off. It was perhaps best for him to say nothing.

"If he did survive to term could we see him?" Cora whispered, her eyes brimming with tears.

"Cora, darling," Robert said, reaching over to take her face in his hands.

"Perhaps," Dr. Clarkson said, "It may be worse that way."

"Will he—will he be in pain? If I. . .if I don't. . ." Cora hiccuped as Robert moved closer to her on the bed, taking her into his arms.

"While the fetus is still in utero it is. . .effectively sedate," Dr. Clarkson offered, "The neural pathways for feeling pain begin to develop at 24 weeks, but pain is not experienced until after the baby is born and the umbilical cord clamped*."

Robert sighed, running his hands through Cora's hair as he pressed her against his chest, "If the baby survived the birth — would he — would he be in pain then? Until he. . ." he let out a shuddered breath, trying to hold back his own tears.

"Newborns can experience pain immediately after birth," Dr. Clarkson said, "If tests and procedures are performed, they feel discomfort just like you and me. So, given the extent of the deformities the baby would be born with. . .it's reasonable to consider that his hours or day of life would be, at the very least, unpleasant."

"Oh God, Robert," Cora cried, grasping his lapels and burying her face against him.

"When do we need to make a decision?" Robert asked, looking at Dr. Clarkson helplessly.

"Sooner rather than later. Should you choose to terminate, there is a window of time during the second trimester where we could complete a dilation and evacuation. If it should happen later. . .we would need to induce a preterm delivery and. . .it could be even more traumatic."

Robert sighed, rubbing Cora's back gently, "Thank you, Richard. We are . . . incredibly grateful to you."

"I only wish it could have been just simply a flu," Dr. Clarkson said, his own eyes beginning to dampen, "I'll leave you — but I won't be far. If you have more questions. If either of you need anything — or the girls — just call."

"We will. Thank you."

Dr. Clarkson nodded and left the room soundlessly, so quietly in fact that Cora didn't even realize he'd left until she lifted her head for a breath and realized he was no longer standing next to her hospital bed. Robert moved to gently lay her back against the pillows, tucking an errant strand of hair behind her ear.

"Robert, I'm so sorry," Cora whispered, tears streaming down her face, "I wanted you to have a son, I wanted to give you a son —"

"You've nothing to be sorry for, darling," he said, feeling his own tears beginning to dampen his cheeks, his chin.

Cora only cried harder, struggling to catch her breath. After a moment, her eyes widened, and pressed her hand against the top of her belly. Robert flicked his gaze down, only to lift it a moment later, focusing on her haunted expression.

"I can't do this," she breathed, "I can't spend the next few months feeling him, knowing that he — that he—"

Robert reached up to wipe the tears from his face, then let his hand hover over her belly a moment, not clear on whether he was asking her permission — or trying to decide if he could stand to form the memory of what he knew he would feel.

"You don't have to, Robert," Cora said, lifting her hand to nudge his away. But that decided for him, and without a word, without so much as a breath, he laid his hand over hers and together, they stepped into grief.

Δ

Cora had been moved to an inpatient room not long after Dr. Clarkson had appeared, and Sybil had been ceremoniously kicked out of the room while they talked. She slumped against the wall and watched nurses bumbling in and out of patient rooms and was silently listing off possibly diagnoses when she heard the unmistakable sound of her Aunt Rosamund coming down the hall.

"Sybil, darling," she said, "What's happened? Your father texted me—"

"Something's wrong with the baby," Sybil said quietly, hugging her knees to her chest.

"Oh fuck," Rosamund breathed, covering her face with her hands. Peeking around them, she looked behind her and then, without paying any mind to her pencil skirt, slunk down the length of the wall to sit next to Sybil on the cold, tile floor.

Neither spoke for a moment, the unit thrumming around them. After a few minutes, Rosamund reached over and took Sybil's hand, letting her head lean back against the wall, her eyes fluttering closed.

"Did your mum ever tell you the story of how you tried to stop my wedding to your uncle Duke?" Rosamund said, giving her hand a squeeze.

Sybil furrowed her brow, "Wasn't I like, a month old when you married him?"

Rosamund chuckled, "Not even — maybe three weeks? Your poor mum was exhausted. I let her off bridesmaid duty. You were an absolute peach the whole ceremony, slept soundly, didn't make a peep — until your father gave me away — he did, you know, because our father had passed — but when the minister asked if anyone objected to the marriage — you know, speak now or forever hold your piece— you started to fuss! Rang out through the whole chapel, your little mewls of discontent," she laughed, pressing her fingers to her lips, "Poor Cora, she was so embarrassed. And you know her, she tears up when she's embarrassed, so then she started to cry — _Ros, she doesn't mean it! She doesn't mean it! _Her hormones were still a royal mess and of course the entire church started to laugh — and Cora fumbled around for your pacifier and stuck it into your little mouth and on we went. Then when we headed down the aisle after the vows, Duke paused right in front of the pew, leaned down, and kissed you right on the nose."

Sybil grinned, "So, I was mouthy from the start — is that what you're saying?"

"Precisely what I'm saying, luvvie," Rosamund laughed, pulling Sybil's hand into her lap. They both looked up as a curious nurse passed them by — but decided against asking _why _they were in a heap on the floor.

"Did you and Uncle Duke ever want your own kids?"

Rosamund sighed, "We didn't . . ._not _want them. It was just never the right time. We tried a few times. . .right after we were married. It didn't. . .it just didn't happen and then I started heading the department and. . .well," she let her head loll toward Sybil, "but we loved being your auntie and unckie, even if you did try to stop our nuptials," she said, reaching over and tapping Sybil on the nose.

"I miss him," Sybil said quietly, "We never, ever see Uncle Harry. Or Grammie Martha. You and Duke were always there at Christmas and our birthdays," Sybil giggled, "And Duke was funny. He would have been a really good Dad."

Rosamund felt her chest tighten and she fought against it— fought against being pulled back into faded memories that were still —_always_—painfully raw.

"He would have been many good things," Rosamund said quietly, "He was many good things — he was — all that was good about me, really," she sighed, letting her eyes close, "I loved him, Sybbie. So much. More than. . .more than I thought I could love anyone."

"Oh, Auntie Ros, I'm sorry," Sybil whispered, leaning her head on Rosamund's shoulder.

"It's okay, darling," Rosamund said, stroking her hair, "I wish he were here for all this. He'd know what to do. He'd . . .he'd make it all right."

The door to Cora's room opened and they both looked up as Robert stuck his head around the corner, his eyes settling on them — somewhat perplexed.

"Hi Bobby," Rosamund said quietly, giving Sybil a light squeeze.

"Um. . .Syb, go sit with your mum. I've got to talk to Auntie Ros."

Sybil clamored to get up, and practically ran into Cora's room. Robert pulled the door to and glanced down at Rosamund, who pet the floor next to her.

Robert hesitated, and Rosamund gave him a look.

"C'mon Bobby. Sink to my level."

Δ

"Mary?"

Looking up from the computer where she had been finishing her documentation, Mary was somewhat miffed to see Edith standing next to her.

"What do you want," Mary sighed, not looking up from her work.

"Mum's here," Edith said softly.

"No surprise," Mary said, "But she's late to the party. Dad's already given his statement."

"She's not here for that. She's in a room."

Mary did look up then — "What?"

"Dad said. . .there's something wrong with the baby. She's sick and. . .well, he said we should come."

Mary stiffened, "Just let me finish this and —"

"I don't think we should wait, Mary." Edith said, "Just leave it."

Mary nodded, rising slowly from her seat. Then, she and Edith took off wordlessly down the hall.

Δ

"Isobel there is nothing that you could say that would inspire me to lift my ass from this chair," Violet said, pinching her nose between her thumb and forefinger, "I don't know where you've been — because you've certainly not been here, helping me, but this is the first moment I've had alone today and I do not intend to let you ruin it."

"It's Cora," Isobel said quietly,

"Oh, for fuck's sake it's_ always_ Cora," Violet snapped, banging her hand down hard against her desk, "I'm not pleased that she wasn't here for Robert's statement—"

"She's here now—"

"Well, does she want a medal?"

"Violet, christ, stop it." Isobel said sharply, "She's a patient. The baby . . ." her voice trailed off and she felt her throat begin to ache, "She's going to lose the baby, Violet."

"What?" Violet whispered, "What do you mean?"

"Robert's with her now. They've talked to the doctors but. . .you should come down."

Violet said nothing, just shakily rose from her desk and took a few hesitant steps across the length of her office to Isobel. When she stood before her, _her friend, perhaps her only friend, _she did not resist when Isobel reached down and took her hand, giving it a consoling squeeze.

Δ

"More tea, love?" Elsie said, reaching across the table for the teapot. Anna shook her head, tucking her hands beneath her thighs as she sat at the kitchen table across from Elsie.

"No," she said quietly, "I really should get going. I was just going to wait for Dr. Carson to come back so you wouldn't have to be alone,"

Elsie sighed, "You're very kind," she said, "I hope you feel a bit better. Now that we talked and got it all mostly sorted."

"I do," Anna said, offering her a hopeful smile, "I don't know what I'd do without you, Dr. Hughes. Really, I don't know what Downton would do without you and Dr. Carson."

"Speaking of," Elsie said, turning to look at the wall clock, "I wonder where he's gotten off to, Good lord. Did he go to Glasgow to get the shortbread?"

Anna giggled, "He _would_."

Elsie hummed a light laugh, then downed the last of her tea, "I owe him, though. He's kept me from splitting my seams — well, at least he managed to sew them up when I did rip them. . ."

"_Ouch_," Anna hissed, "Well, not that it's any of my business, but I'm awfully glad you two are finally an item — now don't worry, I won't say a word. I certainly didn't mean to go stumbling in on your secret."

Elsie frowned, "What?"

"Well, you know. He's . . .he's not here as your doctor."

"Well, no, I suppose he's not —"

"I swear I won't say a thing — but I'm happy. I'm happy for both of you."

"Anna, wait a minute," Elsie said, laughing nervously, "What are you on about?"

Anna blinked, her face falling, "I just. . .I saw the blankets and the pillow and thought, well, I just assumed," her face flushed and she brought her fingers to her lips, "Oh, Dr. Hughes, I'm so sorry. I'm so embarrassed."

Elsie opened her mouth to protest, but was cut short by Dr. Carson plowing through the front door, his arms full of brown paper bags, heaped with groceries.

"I got the biscuits and a few other things — figured you'd not protest if I —" Charles began, but as he came around the corner, he startled at the sight of Anna, "Oh, Anna! Sorry, didn't meant to interrupt."

"I was just leaving, Dr. Carson. Only dropped by to look in on our patient but I see she's in very good hands," Anna said, getting up from the table. She nodded to Elsie, and headed toward the hall, but Charles stopped her.

"Are _you _okay, Anna?" he asked quietly, "I hope you aren't leaving on account of me. Certainly if you'd. . .you'd prefer to stay, so you're not alone this evening—?"

"I won't be alone, Dr. Carson. Dr. Bates is off his shift now and he'll keep me company," she leaned in, lifting herself up on her tiptoes to whisper in his ear, "And I hope you'll be doing the same for Dr. Hughes?"

He flushed, looking down at her as she gave him a knowing glance.

"I'm doing my best to," he said after a moment, the grocery bags rustling in his arms.

"Well, I'll leave you to it," Anna said, turning to give a slight wave to Elsie.

"Anna?" she called, "Do give me a call in the morning? Let me know how you're feeling?"

"I will," Anna said quietly, flicking her gaze up to Dr. Carson, "but not too early, promise."

Charles hovered awkwardly in the hallway a moment until Anna had left, then, took a few uncertain steps into the kitchen, clutching the grocery bags to his chest.

"Nice of her to stop by," he mumbled, suddenly feeling entirely out of place in her apartment — though she had asked him to stay.

"She's doing remarkably well, considering," Elsie said, stifling a yawn, "She has a brave heart, that girl does."

"I suspect it takes one to know one," Charles said, moving to set the groceries down on the sideboards. He heard her giggle from the table.

"Either you bought up all the Walkers' in Chiswick or you deviated from my request slightly."

"Added to, perhaps," he said, "I can't, in good faith, as your doctor, condone you subsisting on shortbread for the duration of your recovery."

"Well," she said, leaning back in her chair, "If there's a dram or two of whiskey in there, I'll be all set. I'm a Scot, aye?"

He turned over his shoulder to look at her, raising his eyebrows, "No haggis?"

She shrugged, "It's not terrible if it's done right. . ."

"I'd prefer not to know what it means to do haggis _wrong,_" he laughed, lifting a box of biscuits from the bag and handing them to her, "Dig in, then."

He turned back to unpacking his wares and she opened the box, taking out a biscuit, hesitating a moment, then taking another, before closing it again.

"Thank you, Dr. Carson," she said quietly, suddenly feeling a bit shy.

"You're most welcome, Dr. Hughes," he said, struggling not to drop each item as he lifted it from the bag; and Charles Carson, accomplished surgeon, was not a man of shaking hands and tenuous nerves.

Elsie's phone buzzed in her pocket; she'd nearly forgotten about it, but the demanding hum against her upper thigh served as either an intrusion or a reprieve from the thickened air in the room; she wasn't sure which. Squinting at the phone, she saw that Anna had texted her.

ANNA: (5:48 PM)

Dr. Hughes! Sorry. I know I just left, but I realized I forgot to return your jumper. Shall I just return it next time I see you?

ELSIE (5:49 PM)

That'll be fine, dear. Keep it for now—then I won't worry about you catching a chill.

Setting her phone down on the table, she laughed, letting it dissolve into a pleased little hum.

"What's that about then?" Charles asked, leaning against the counter after he'd put the last of the groceries into the refrigerator.

"Anna — sweet girl. I'd let her borrow a jumper of mine while we were sitting here. She ran off with it by mistake."

Charles blinked, "Was she cold?"

"Shivering, just about," Elsie said quietly — then, she stopped short, something sending her own body shuddering. A sudden memory. She flicked her gaze up at him and he met it, unwavering.

"I wasn't sure . . .if you remembered anything about last night," he said deliberately,

"_Oh God_," she mouthed, her cheeks pinking up, "Dr. Carson — I was — as you well know, I was sedated. Practically anesthetized. Anything that I did, or _said—_"

"Dr. Hughes — no, no. Nothing . . .improper happened. You . . .from the anesthesia. You had the shakes — you know that happens from time to time. A patient gets those painful, uncontrollable shivers in recovery and. . .you try to calm them."

Elsie swallowed hard, looking down at her lap, "Somehow I doubt you crawl into bed and hold every patient with post-operative shivering,"

He cleared his throat, gripping the edge of the counter in a futile attempt to steady himself, "No — no, I suppose not but —"

A wavering silence passed between them as he let his thought hang there — she wasn't sure what had intended to say but she was abruptly overwhelmed by the realization that she knew what she'd wanted him to imply: that she was different, special, even. More than a patient, more than a . . .friend.

"Maybe I should go," he said, though his words were so weak that he didn't even seem to believe it to be the best possible course of action.

"No," she said, perhaps a little too loudly; she thought she saw him startle slightly.

"I can at least help you fix a proper meal," he said, nodding to the biscuit crumbs on the table beneath her hands, "As I said, you can't live off those."

She gave him a small smile, then immediately pressed her lips together to stifle it, "Dr. Carson, I . . .I hope you don't think me ungrateful."

"Not at all," he frowned, "Whyever would I think that?"

"I didn't think for one moment that you'd done anything improper," she said, "I didn't trust that I'd not done something. . ." she felt the heat rising in her face and goosebumps tickled her arms, ". . .you know, the sedatives. The trauma. I might have done something rash."

"You didn't," he said quietly, "You shook for a bit. Then you slept," he took a few steps toward her, then slowly lowered himself into the chair across from her at the table.

"I don't snore, do I?" she asked, biting her lip slightly.

He raised his eyebrows slightly, opening up his face in gentle empathy.

"No," he said sweetly, "You don't."

They smiled shyly at one another, then, he sighed — drumming his fingers on the tabletop, "If you'd like me to stay this evening I'll fix up the couch in your den. Which, I hear, is not half-bad."

She snorted, then covered her mouth self consciously, "I suppose you wouldn't know, would you?"

He waggled his eyebrows at her, "I should really run home and grab my overnight bag, though. I've amassed more than a 5 o'clock shadow at this point in the day and I really need a change of clothes."

"That seems reasonable," she said quietly, so quietly in fact that he didn't quite hear her, so he leaned across the table a bit. When she looked up, she was a bit taken aback to find him much closer.

"Only if you'd like me to stay. If you're feeling well then perhaps you'd rather —"

"Is it so terrible to admit I don't really like the idea of being alone?"

"Not at all," he said, "I can't say I'd sleep well if I were, given all that's happened. And I don't even have healing stitches to keep me up all night."

She reached across the table and took his hand, "Thank you, Dr. Carson. Really. Thank you for. . .your generosity, but also, for not thinking me silly."

"For what?" he said, shaking his head slightly, "I'd say you've had a perfectly reasonable reaction to everything that's transpired in the last twenty-four hours."

"But what about the last . . .twenty-four _years_?" she said, locking eyes with him.

He watched as a small smile twitched at the corners of her mouth, the way she rolled her lips tightly together to quiet it — but he could see it twinkling in her eye, and it made something stir deep within him — made him want to laugh and cry all on the same breath.

"Well. . ." he said, his voice rumbling low in his throat, "To quote Longfellow, _Nothing is too late, 'till the tired heart shall cease to palpitate._

* * *

* This particular genetic condition worked well given Cora's medical history; still, it's devastating, but I needed to create a medically believable circumstance.

*Terminations are, in a few states in the U.S., not even legal in the second trimester. The usual method is a little more advanced than a 1st trimester termination and it's called a Dilation and Evacuation.

* I know this is really densely scientific and "medicalese" — but they have studied this rather extensively because it's an oft-quoted aspect of the Pro Life/Pro Choice debate. I don't want to impart any personal belief here, but because this story is founded in real medicine — I'm focusing on what is supported with peer-reviewed research because that's the only way the story can be written and continue to be accurate and education — and not just entertainment. It's true that the neurological pathways for pain begin develop at around 24 weeks, but they are not advance enough for actual pain. Pain itself is an incredibly complex process that we don't even fully understand in adults — but we're learning more and more about it.


	30. Signs of Life

**A/N: **I KNOW ANOTHER UPDATE AND IT'S A HUGE ONE BUT IT'S HEAVY AND I THINK WE ALL NEED TO PROCESS IT. I didn't put notes at the end because I didn't know how much people wanted to know about the medicine in this chapter; but if you have questions PLEASE message me. I will talk more about it at length to anyone who wants to know, for whatever reason. I have all the papers I referenced in a folder!

* * *

"You should go home and sleep," Cora whispered. Robert looked up from where he'd started to doze off in the recliner next to her hospital bed; he'd thought she'd long since fallen asleep herself. They'd only just wheeled her back from the procedure room where they had started to prep her for the D &amp; E. The dilators had been placed, medications started, and he knew by the grimace she wore that they were doing their job more than adequately.

He reached over, nudging her hand and lacing his fingers through hers.

"You have a very specific look about you when you're laboring," he said, " I always knew when a baby was imminent because you just. . .you'd get a _look_."

She furrowed her brow at him, "What look?"

He smiled gently, "The one you've got on now."

She relaxed her face, letting her head rest against the pillows, eyes fluttering closed,

"Except they'll be no baby this time," she said simply, her eyes tightening against the discomfort that hummed low in her belly.

"I'll sleep in the chair," he said, "I can't go home. Not tonight. I want to stay with you."

"You really _do_ need to sleep though," she said, "You've had, quite possibly, the worst two days of your life."

"And you haven't?" he said, moving from the chair onto the bed with her, careful not to jostle her too much, "I don't want to be away from you for a moment. I don't think I could bear it. Not with everything that's happened."

She didn't open her eyes, but did squeeze his hand gently, "I know — and I don't _want_ you to leave — but I'm worried you'll pass out from exhaustion."

"I'm made of stronger stuff than that," he said, kissing her temple, "I did survive medical school, residencies, _three_ little girls . . ."

"None of this seems real," Cora whispered, "I'd only just gotten used to the idea that I was pregnant — and now I _won't_ be — it seems like some cruel joke the universe is playing on us. To give us something we've both wanted for so long — and then rip it away. Literally, _rip it_ from us."

Robert stiffened, his body unable to cry more than he already had, but straining to nonetheless, "I can't help but feel that I'm being punished – for what I've done. For what I've _not_ done."

"I don't know," Cora said wearily, "I don't want to ascribe cosmic significance to it. I don't _want_ to give it a reason," she opened her eyes, "We can't do anything to keep _him_. But maybe there's still something left to cling to — in order to keep _Downton_."

"Cora, you can't compare this hospital to our child," he said, his voice still strained.

"It's all you've got left," Cora said frankly, "I don't want to see you lose everything,"

He pressed his lips to her hair again, trailed down the side of her face, kissed the corner of her mouth and then gently took her face in his hand, tenderly pressing his forehead against hers.

"The only thing I couldn't stand to lose — is _you._"

Δ

"Do you need another pillow?"

Charles looked up from his book, to see her hovering in the entryway to the den, wrapping her robe tightly around her.

"I think I'm all set," he said, closing the book onto his finger to hold place, "Have you settled in for the night?"

She sighed, "My old body would appreciate the sleep, but my mind is _racing_," she said, pressing her fingers against her temples, "Do you mind if I sit in here with you for a while?"

Clamoring to put his book on the coffee table and turn himself into a sitting position, he nodded, "Not at all — come have a seat," he said, petting the couch next to him.

"Oh, you looked so comfortable," she mused, making her way toward one of the corner chairs, "Don't let me disturb you."

Feeling a bit insecure at his willingness to invite her so close, he bunched up the blanket and sat it on the cushions next to him — filling a void he'd have much rather lent to her soft warmth.

"I was thinking about how we've been at Downton all these years — steady on toward retirement, even — and it seems that everything's unraveled overnight," she marveled, biting her thumbnail. After a moment, she grinned overtop where her finger rested against her pouted lip, "You know, I remember the first time I met you."

"Oh?" he said, resting his hands in his lap, "And what of it?"

"My first thought was — _my, he's a rather tall lad!_"

Charles chuckled, "Well, I was lankier; something of a beanpole in those days."

"Well _I_ certainly was slighter back then, a bit of a thing. Though, it only took a few mornings of doing rounds with _you_ in flats to convince me I'd better invest in at least a few decent pairs of pumps."

"Is that why you started wearing high heels every day?" he said, clearly delighted, "I just assumed it was for fashion's sake."

She bit her lip prettily, her eyes twinkling a bit, "No, 'twas you — but you didn't let me finish my story."

"Oh, sorry," he said, leaning back against the couch cushions, "Carry on."

"_Well_," she said, crossing her legs, "It was the beginning of summer — I remember because my flat in London didn't have any kind of air conditioning unit and I would lay out all my charts in the middle of the floor and splay myself out on damp towels to cool off," she closed her eyes a moment, releasing herself to the nostalgia that welled up in her, "I'd just turned thirty, resigned to spinsterhood as it were. Though I think I was more of a bachelor if anything — my place was always a tip because I was hardly there, and when I was, I was sleeping mostly. My hair was a bit longer, had maybe a fistful of grays," she raised her eyes to his, "If I recall, I don't think _you_ had a single gray hair then. . ."

He smiled, perfectly chuffed, "Correct — I was _only_ thirty-six."

"I was thinking of when we met — but you know, I actually saw you _before_ that."

"Oh?"

"Mhm. I was getting my tour — walking through your unit. A nurse offered to interrupt you so that we could be properly introduced but I told them never to mind. I'd come back when you weren't with a patient."

"Was I?" he said, not remembering precisely.

"You were — it was a child. Something relatively harmless, I think. Might have been ear tubes or a tonsillectomy. But she was clearly terrified and you very calmly, patiently explaining what was going to happen. The parents seemed very grateful."

"I can't say I remember — there were many in those days. Of that procedure, I mean. Well, many surgeries in general if I'm honest. I think I spent more hours warming my hands in someone else's body than I did not."

She blushed, "I don't know how, but you managed to make that sound a bit _risque_, Dr. Carson."

He snorted, shaking his head, "And if I did?" He shrugged, raising his hands up and letting them settle on top of his head, his arms angled, framing his face.

"I did find you rather handsome," she stumbled, waving her hand in front of her face as though she was trying to clear her clumsy words from the air, "You know, quite comely."

Eyebrows flared, he chuckled, "You _did_?" he said, feigning disappointment. She started to speak, to defend it, but he shushed her — "What about the first time I saw _you_?"

Elsie shrugged, "I suppose when we were introduced, on the unit —?"

He shook his head, "No, much like you, my first glimpse of the _recondite Dr. Hughes _was a stolen one."

She blushed, "Oh?"

He pursed his lips, furthering the anticipation by furthering his silence, "_Well_," he began slowly, agonizingly. She felt her heart triple-beat in her chest. She wondered, for a moment, if it was possible to experience deep longing to the point of an arrhythmia.

He sighed, letting his hands drop to his sides, crossing one leg over the other so his ankle rested atop his opposite knee, "It was quite a reveal, actually. Like how they frame a shot in a movie — I was walking down the main thoroughfare, blearily looking for coffee I suppose, and you were at the front desk with your trench coat and briefcase. Your hair was down, which clued me in that you were new, because back then none of the female physicians _ever _wore their hair down — if they kept it long at all. I paused at the switchboard, hung back a bit, tried to figure out who you were. And you turned, heading toward me. . .my first thought was, you walked like a monarch. Deliberate, assured steps — not too quickly, but with a certain authority that made people take one step to the side as you made your way down the hall. As you got a bit closer, I saw that you had a white coat beneath the trench — smart, because it'd been a wet summer, and certainly you didn't want to show up sopping wet to your first shift — and I got a mere glance at your badge. Enough to see that your first name —" he paused, watching her tuck her lip beneath her front teeth again, "— _was Elsie_."

"And then?" she said, waiting on baited breath.

"And then _what_?" he laughed, "You breezed _right_ by me. Didn't even say good morning. But I hardly took it personally; you seemed a bit preoccupied. I figured I'd meet you soon enough and properly introduce myself. But, of course, when I ran back to surgery and everyone was nattering on about the new doctor, I was quite chuffed to have been the first to see you in the flesh," he said.

She opened her mouth to speak, but almost immediately closed it. Reaching up to massage her neck, she craned her head around to look at the clock on the bookcase.

"I should probably try to get some sleep," she said, encouraging a small yawn as she made to stand up, easing herself from the armchair.

"Aren't you going to ask?" he said, not moving from his spot on the couch.

"Ask what?" she said, folding her arms across her chest — then thinking better of it as she inadvertantly pressed her tender breast a bit too hard.

"If I thought you were . . ._comely_?" he said, his mouth rolling over the word.

She felt how deeply she had blushed, "Oh, Dr. Carson —" she protested, stuffing her hands into the pockets of her robe.

"I did," he said quietly, "I do."

"Dr. Carson, you flatter me. I feel like I should go have a look in the mirror and make sure my hair's tidy."

He smiled, giving her a toothy grin — she couldn't remember ever seeing him smile like that before, "Get away with you," he rumbled, giving her a teasing glance as he pointed toward her bedroom door.

Δ

"I thought I'd find you here,"

Dr. Clarkson looked up into the darkness of the hall; recognizing the voice right away, it took him a moment to see her figure standing in the black-blue night of the hallway. It had been a long time since he'd stolen away to one of the rarely-traveled service hallways behind the surgical suites, but it was one place he could always guarantee he'd be left alone. At least until his pager bleeped or an overhead page interrupted his thoughts.

Hopping up on the stretcher next to him, her feet dangling over, Isobel tucked her hands under her thighs and looked down the hall into the abyss, waiting for him to speak. He didn't feel pressured to say anything; she'd wait. And he was grateful for it.

"Technically, Dr. Tapsell should do the procedure," he said, tapping his fingers lightly on the pile of textbooks that built a tiny wall between them on the stretcher, "But I don't feel that I can allow him to."

Isobel frowned, and though he couldn't have made out that much in the dark, her voice was furrowed in kind, "Under no circumstances should he do the procedure," she said quickly, "As far as I'm concerned he should be off her care entirely!"

"He's the specialist — and the surgeon," Dr. Clarkson said, "I've only done a handful in my time. Mostly I've taken care of the first trimester terminations but D and E's. . ."

"Do you not feel confident in your technique?" Isobel asked gently.

"No, not that — I'm torn between thinking my friendship with the Crawleys should prohibit me from performing it while at the same time, I almost feel as though it means that I must," he turned to her desperately, "It's not that I question Dr. Tapsell's technique. In fact, given his profession, I'd wager his would be superior to mine without question — but he possesses no tenderness. No empathy. And I feel . . . no, I know that in this case, that will be the difference in the healing of that family."

Isobel sighed, "I think that's your answer right there isn't it, Richard?"

He looked up at her sharply at the sound of his name; how many years they'd known one another, worked alongside one another. He'd known her husband, another Dr. Crawley as it were, and knew of her father and brother — the doctors Turnbull, who maintained a family practice in Manchester. She'd taken a nursing job in his practice so that she'd have working hours that would allow her to pick up Matthew at kindergarten and have dinner on the table by seven o'clock each night. But when her husband had died, and Matthew had gone off to pursue his own career in medicine, she'd slowly taken to staying at the office longer. He'd always enjoyed her company, of course. Thought she was kind, intelligent — and he'd be a liar if he'd not admit to finding her breathtaking. She had the deepest, most emotionally compelling brown eyes he'd ever seen, and whether she was wrapping a cuff around a patient's arm or tucking the phone against her shoulder, her movements were so fluid and smooth that he often got lost watching her practised choreography play out each day that they danced around one another in his tiny office.

Still, he'd never found the way to tell her these things, and what with the walls of the palace crumbling around them, or so it seemed — he began to think he never would.

Δ

Robert, Rosamund, Violet and the girls had gone off for a late dinner, hoping that Cora would sleep. Of course she didn't, but practised in the art of feigning sleep with stable breathes and fluttering eyelids, she managed to convince them. When she opened her eyes, however, she realized she'd been caught out.

Sybil stood hovering in the doorway to the small washroom.

"I _knew_ you weren't asleep," she said, crossing the room and crawling up onto the bed next to Cora, giving her a playful, admonishing shake of her finger.

"I think you've spent more time cuddled up in bed next to me in the last six weeks as you have since you were six years old," Cora said, opening her arms as Sybil relaxed eagerly against her chest.

"If it's bothering you—" Sybil started, lifting her head — but Cora pulled her back down, kissing the top of her head.

"Sybil, I will _never_ be bothered by you._ By this_," she sighed against her daughter's sweet smelling hair, "I feel blessed that you still let me. I can't imagine ever having the chance to cuddle Edith or Mary again. They're so long beyond that."

"I saw this thing on the internet the other day — someone said something like, _there was one time when your mum put you down and never picked you up again, _and I thought that was so terribly sad," Sybil said quietly, "Mum — I'm so sorry about the baby. I don't even know what to say."

"You don't have to say anything," Cora said, "Thank you for letting me hold you, though. It helps," blinking away tears, she pulled Sybil tighter, burying her nose in her soft hair, "You'll always be my baby — _my beauty and my baby_."

Δ

Other than to address the entire family on Cora's situation, Robert had not spoken to Violet. Somewhat uncharacteristically, Violet herself had not spoken since they left the hospital room and headed toward the parking lot, hoping to find a pub nearby that was still serving chips at the very least. They went to a spot that Rosamund frequented, and although her boisterous compatriots seemed happy to see her, they immediately quieted when they noticed the somber air the family brought with them as they piled into a table and ordered stiff drinks all around.

When the silence became all too suffocating, and alcohol had arrived and become something of a social lubricant, Edith spoke up.

"I think we should arrange for Mum to see a counselor," she said, nursing her wine.

Robert blinked, "Oh — well, certainly, if she feels she needs it."

"Or you could just mount a preemptive strike," Mary said, the ice cubes in her white wine (the only way she'd drink it) clinking against the side of the glass, "Because you know, after the first week, she'll be_ right_ back to her old self — she'll bury any feelings she has on the subject and the focus will be right back to Dad's drama."

Robert's face went scarlet, not from anger, but from his daughter's blaring honesty.

"I don't think there's anything wrong with being prepared," Rosamund said quietly, stroking the rim of her scotch glass, "It certainly beats sitting around feeling as though you can do nothing but watch everything fall apart . . ."

Everyone took the pause to sip at their drinks — except for Rosamund, who downed her _third _scotch with a rather impressive gulp. Violet cleared her throat, pretending to dig through her purse for something.

"Gram, are you alright? You're awfully quiet," Edith said, reaching across the table to put her hand atop Violet's.

She looked up, startled, "Oh! Edith, I'm fine. Don't worry. Just shocked, overtired, and realizing I've left my beta blockers at home."

"That's unlike you, mum." Robert said.

"Well, _pardon me_ Robert but it's been a rather rough few days and I suppose maybe I'm not on my game — surely you'll spare me?"

Robert cowered a bit, sipping his brandy. Rosamund glared overtop her empty glass, raising a hand to signal the waiter for another.

"You're insufferable," Rosamund spat, leaning toward Violet, "You don't get to feel a _god damned_ thing about this — you were against this baby from the beginning, and now, you're getting your wish—"

"Rosamund," Robert warned, "You're _drunk_, you shouldn't speak—"

"Quiet, Bobby, someone's got to say it — and it might as well be me," she braced herself against the table and glared down at her mother, "By this time tomorrow night, what would have been your fourth grand child —_ your only grandson_— will be reduced to a heap of ashes to be spread in the garden of miscarried children on the hospital grounds—"

"Rosamund, I am your _mother_—" Violet hissed, staring up at her daughter.

"You wanted her to abort, and guess what? Now she _has_ to. The universe has spoken, _dear mama _and as per usual, you're getting_ exactly_ what you wanted—"

"— you can't speak to me this way!"

Rosamund lowered herself down unsteadily, keeping her eyes on Violet, "You must have read somewhere that being a callous bitch is acceptable in one's old age, mummy dearest, but you would be _terribly_ mistaken."

"Rosamund, please," Robert said, "Don't make a scene."

"Don't mean a scene? Bobby, _how dare you_, how dare you tell me not to make a scene, when you've gone and bloody single-handedly destroyed the entire Downton empire with your shitty, selfish decisions —"

"Auntie Ros," Edith implored, reaching a hand over to grip hers, "C'mon, let's go, I'll drive you home—"

"Get your hands off me," Rosamund snarled, wrenching her arm from Edith's grasp. Blowing a puff of air up at the fallen hair in her face, she reached over and gave Mary a hard poke in the arm, "What about you — Mary, _Queen of Thoughts_ — what are you over there sulking for? You've been fairly vocally opposed to all this. Your little hissy fit at dinner—"

"Rosamund, _jesus christ_ you're belligerent," Robert said, rubbing his eyes with the heels of his hands.

"Actually, Rosamund, I'm just sad," Mary said levelly, "I'm sad for mum because I know how terrible it feels to have something within your reach, yet snatched away before you ever get the chance to —" her voice faltered, and she shook her head, quickly grabbing her purse and pushing her chair back from the table, "Dad, I'm sorry, I've got to go home. I'll see you in the morning."

"C'mon Auntie Ros, please, let me take you home," Edith said, looking at her father nervously.

"Fine," Rosamund said, shaking the table as she stood. Edith paused to kiss Robert's cheek, then Violet's and then hastily lead Rosamund out the door of the pub.

Alone in exhausted silence for a moment, neither Robert nor Violet spoke. Instead, she reached over and laid her hand atop his, patting it gently.

"I never meant—" she started, but Robert covered her hand with his.

"I know, mum," he said, leaning over to kiss her cheek, "Are you going to be alright? Shall I take you home, then?"

Violet sighed, nudging the glasses and plates away, "Yes, but before we do, let's have a look at their desserts. We've had a terrible time of it, haven't we?" she said, putting her glasses on, "Seems a pity to miss out on a good pudding."

Δ

Phyllis rapped lightly on the door to Cora Crawley's room before pushing it open. It was just after 5, and she was working a swing shift in OB before heading to pedes. She'd only been doubling up for a few weeks and it was exhausting, but she needed the money — besides, it wasn't like she had anything waiting for her at home, really.

She'd hardly expected to start her shift looking in on the wife of the hospital's Dean of Medicine, however. Least of all on what would probably prove to be the worst day of the poor woman's life.

Not expecting to find Robert Crawley in her room — since she'd passed him in the lobby on her way in (he was, presumably heading out for breakfast — or maybe he just needed a moment alone. She didn't ask) she wasn't startled to find that Cora was by herself, sleeping as soundly as someone could in a bed that wasn't their own.

"Mrs. Crawley?" Phyllis said, pressing her fingers against Cora's wrist to feel her pulse.

Cora sighed, struggling to open her eyes, "Hmm?"

"My name is Phyllis Baxter, I'll be your nurse this morning. . ." she said, reaching to pull the mobile computer unit closer to Cora's bed so that she could record her vitals.

"Good morning," Cora said blearily. She blinked a few times and then furrowed her brow "Don't you work on pedes?" she asked, "I feel like I've seen you somewhere. . ."

"I do," Phyllis nodded, "But I'm on a swing shift — I just go where I'm needed."

Cora smiled, "That's good of you," she moved to sit up, but almost immediately moaned into the grinding pain in her lower back.

"How's that pain?" Phyllis said, "You had the osmotic dilators placed last night?"

Cora nodded, "It doesn't hurt as much as true labor but it's not exactly a pleasant feeling to wake up to."

"I'm terribly sorry for your loss—" Phyllis began, but Cora sighed wearily.

"I've not lost him _yet,_" she said gently, almost apologetically, "I suppose I should ask when they'll be in to. . ._to um_. . ."

Phyllis glanced up at Cora's chart, "Actually, he should be in shortly. I believe they wanted to do the injection a few hours before your procedure. To be certain."

Cora nodded, "Robert's stepped out — they'll wait for him to return?"

"Of course," Phyllis said, reaching for the blood pressure cuff, "You won't be alone."

"Do you. . .do you know if, um, if he'll feel anything?"

"The baby?" Phyllis asked softly, "No, he won't. Neither will you. They'll give you a bit of lidocaine first, right about here," she said, laying a hand on Cora's belly, "Then they'll take a needle and inject the potassium chloride into the umbilical cord."

"And his heart will stop."

"Yes."

Cora let out a shuddering sigh, blinking back tears, "But he won't be in pain?"

Phyllis shook her head, "No," she cooed, "And he won't be alone for a moment, because he'll not leave that warm little place until long after his soul's departed."

Cora blinked up at her, her mouth forming a soft _Oh, _"Thank you," she whispered, "I hadn't thought about it like that but — you're right, really. If he can't live than. . ." she reached up to wipe the tears that had fallen onto her cheeks, ". . .at least he'll be safe and warm when he goes."

"And loved," Phyllis said, putting her hand on Cora's forearm.

"I would have loved him so much," Cora said quietly, taking Phyllis' hand for its warmth.

"You _do_ love him," Phyllis said, "You _are_ loving him. You always will. No need to deny yourself that."

Cora nodded, unable to gather herself to speak, but it hardly mattered. Robert came bumbling in and Phyllis instinctively pulled her hand from Cora's, turning back to the computer.

"Hello darling," Cora said, wiping her face, "Did you find coffee?"

Robert grunted, lifting the takeaway coffee he had in one hand.

"Nothing to eat?" she asked, punching the pillow behind her into submission.

"No. Not hungry." Robert said, nodding to Phyllis as he crossed the room to sit.

"I'm sure you already know you're NPO status until after the procedure," Phyllis said, stuffing her hands in her scrub pockets, "They'll be in shortly. If you need anything, or if there's anything you'd like for after — please let me know."

Cora smiled, "Thank you. You've been so kind."

Phyllis nodded to her, then once again to Robert, before quietly exiting the room.

"She seems like a gentle soul," Robert said, sipping his coffee, "She looks vaguely familiar."

"She's from pedes; but she swings here, I guess." Cora sighed, turning her head toward him, "The nurses should be paid enough that they don't have to swing shifts, Robert."

"Let's not talk about that right now," he said, setting his coffee cup down on the small table next to the bed, "How are you feeling?"

She raised her eyebrows at him as if to say _isn't it obvious? _

"I mean — well, how's the pain? From the dilation? It should be nearly done."

"It's tolerable," she said calmly, holding her hand out to him. He took it, bringing it to his lips as he moved to sit on the edge of the bed.

"I want to ask you something but I'm afraid to," he murmured, "At risk of making this even more painful — but I've _got_ to know."

She blinked, looking at him somewhat vacantly. The room was still dark, but the early morning light was creeping in through the blinds and soon, the room would be awash with warm light.

"Had you — had you picked out a name?" he said, reaching up to push a stray hair from her face.

"Had _I_?" she asked, "I'd've consulted you first. . ."

"I know," he said, laughing sadly, "I just thought — well, with the girls you had your favorite names picked out right away. And ultimately we ended up going with your choices because my names were all bollocks,"

"Josephine wasn't _bollocks_," she said, "It's Mary's middle name, is it not?"

"Fine, so maybe they all weren't but —" he looked at her almost desperately, "This would have been different. Boy's names and all. We'd never gotten to talk about that."

"There was only ever one," she said tenderly, reaching up to stroke his face.

He waited, his eyes welling up, "What?"

Sniffling, Cora took his face in her hands, wiping the tears from his cheeks with her thumbs, "_Robert._"

Δ

When she woke, Elsie had almost forgotten about the man sleeping in her den. It occurred to as she lay there, breathing into a deep stretch, that while the couch was decidedly comfortable for _her, _he was so much larger a person that, now that she had her wit's about her, it _couldn't _have been comfortable to him _at all_.

Throwing back the covers, she looked at the clock on her night table: just after six. She'd not heard him rustling about in the other room, but she was almost certain she'd find him awake. A man like Charles Carson was dependable if he was anything.

Sure enough, as she padded down the hall, she began to hear the occasional clinks and clunks from the kitchen, and as she rounded the corner, she saw a familiar tableau from the previous morning.

"You're spoiling me, Dr. Carson," she said, leaning against the doorframe, "What'll I do when you go back to your flat and I've no one here to make my tea?"

He turned from the stove and smiled at her, "Hold your praises for me," he warned, lifting the skillet from the burner, "I've done something you may not be happy about."

"Oh?" she yawned, making her way to the table, "I'm all agog."

He sighed, reaching across the countertop for a spatula, "I've called us both in sick today," he said, looking over his shoulder at her to gauge her reaction.

"_Really_," she said, her voice low and raspy in her chest.

"I received a rather troubling email this morning — I'm sure you got it too, but I doubt you've checked yours."

"I've not," she admitted, picking lint off her robe, "It's to do with Anna, yes?"

He shook his head, reaching into the cabinet for plates. She flushed at the realization that he knew her kitchen well enough to cook in it.

"Something's gone _terribly_ wrong for Cora Crawley — Robert's taking some personal time to deal with, no doubt, the fallout from the scandal, but more importantly the loss of the baby. . ."

Elsie gasped, "Oh, the poor wee babe—" she said, her accent thickening around the words.

"He didn't want it to be mentioned, obviously, but he did want_ us_ to know the truth. She's terminating today. This morning, I think. He'll be out the rest of the week."

"As he _should_ be," Elsie said solemnly, "Though, it sounds as if the ship of Downton will be sailing without a captain — are you sure about taking a mental health day _now?_"

"Well, _only_ today — the rest of the week we will _both_ need to be at our best; returning full force. However, I am _completely_ knackered and I can only assume you're far worse for the wear than I," he turned, holding two, heaping plates of eggs and toast, "So, I made a medically well-advised decision to enforce that we _both _get adequate rest and nourishment today."

He set the plate in front of her, then pushed his to the opposite side of the table, sitting down with a rather exaggerated sigh.

"Well, thank you," she said, reaching for the silverware he'd already laid out. It felt a bit odd sitting down to a proper breakfast. She couldn't remember the last time she prepared herself something requiring cutlery before noon time.

"I won't hound you," he said, "I wanted to be sure you had at least one decent meal today. Then I'll leave you to it."

She felt a bit dejected, "You'll go back to yours then?"

He laughed, popping a bite of toast into his mouth, "I should _eventually._ There are a few potted plants I'm worrying after."

She smirked, "Oh, I see," she bought herself some time by taking a rather large bite of toast. She chewed slowly, then looked up at him, "Were you planning to go straight away?"

He shook his head, reaching for a napkin, "I'll tidy up first—"

"No, no, I didn't mean that," she said, "I. . .I just enjoyed your company last night is all. It was nice to have someone to talk to."

He paused, fork halfway to his mouth, "I admit, I rather enjoyed it myself," he lowered his fork, "I won't rush off if you don't want me too. I was afraid I'd become an intrusion."

"Not at all," she said, "I'm very grateful to you for all your help. I hope I'll have the chance to repay you," she faltered, dropping the piece of toast she'd been holding, "I mean, not that I hope you'll need surgery or anything — just that, well, I don't know. Perhaps I'll treat you to a proper dinner some evening — or drinks at Grenadier."

"You know about Grenadier?" he said, his eyes brightening.

"Of course I do, did you forget I put myself through medical school moonlighting as a barkeep? If there's a halfway decent pub in London I know about it."

He chuckled, reaching for his tea, "I don't want you to think I'm laughing at you, because I'm not, but I have a very hard time imagining you as a bartender. You don't seem . . ._rugged_ enough."

"Ah, but that's why I was brilliant at it was because I wasn't at all what people were expecting, but I sure as hell could hold my own when it was called for."

"I can't see you cutting off a man twice your stature—"

"Dr. Carson, I'd advise you not to cross me — then you'll be certain to find out how I kept all those tosspots in line, even if I was a wee bar wench."

"Duly noted," he said, lowering his tea cup onto its saucer with a definitive clink. He furrowed his brow a moment, then started to speak — swallowing his words instead.

"What were you going to say, Dr. Carson?" Elsie teased, "You've piqued my interest with that little look. . ."

He sighed, "I suppose since we're speaking of our sordid youth, I can share."

"I'm intrigued," she said, "Go on, then."

"I was just wondering if I . . .ever ran into you in a pub. Or the pub where you worked. I was trying to remember where I would go at night. After shows—"

"Shows?"

"Mmm. I had. . .oh, well this is almost too embarrassing to admit . . .I was in a band. Not really a band, it was a duo really. Hall and Oates or Simon and Garfunkel-esque."

Elsie's eyes widened, "Oh, Dr. Carson — was it a rock band?"

"Not exactly," he said, "More . . .um, a singer-songwriter nature. A mate of mine — also named Charles— Charlie. We played some gigs. Nothing terribly exciting."

"What was your name?"

"Hm?"

"For your band or your duo."

He blushed, "_The Cheerful Charlies_. It was. . .meant to be_ ironic_. We sung a lot of ballads."

She smiled, then, widely and with an affection in her eyes that soothed him, "I bet we did cross paths. There was always music at the pub."

"That'd be something, hm?" he said, "But I would have remembered you. A teeny Scots lass behind the bar? I wouldn't have forgotten that."

"You wouldn't have noticed me," she said, "I wasn't much to look at — not that I am now — but not the type of gal a cool, hep to the jive musician - slash - doctor would have had his eye on."

"Well," he sighed, "I did have a gal back then. For a while anyway," he shook his head, looking suddenly deeply pained at the memory, "Anyway, I've gabbed enough on that sorry subject. Let me clear the dishes — your dressing should be all right for you to shower now, if you'd prefer it."

"Are you trying to tell me I need to bathe, Dr. Carson?"

"Oh — no — I just meant—?"

"_Relax_," she said, "I'm only teasing you."

She stood and handed him her plate, "Thank you for breakfast. It was lovely. And not just because I didn't have to cook it."

"Oh. Well, you're very welcome." he said, turning the faucet on.

"Will you be here when I . . .when I've finished my shower?"

He nodded, hands wrist-deep in suds, "I wouldn't leave without saying goodbye."

A smile twitched at her lips, "Good," she said quietly, and walked the whole length of the hallway with a wide grin on her face that nearly hurt. Though somehow, she didn't mind a bit.

Δ

"Cora, we're going to give you a general anesthetic. You won't be under for very long. When you wake up, it will all be over," Dr. Clarkson said, hovering over Cora in the obstetric procedure room, "Or at least — this part of it."

"I know what you mean to say," Cora said, looking up at Robert as Dr. Clarkson stepped away. He took Cora's hand, bringing it to his lips.

"I love you," he said quietly, kissing her fingers tenderly.

"I love you too," she said, squeezing her eyes closed tight, a tear slipping down her cheek "He's gone."

"What do you mean?"

"I stopped feeling him about an hour ago. He was just. . ._gone,_" she said, opening her eyes again.

"You didn't say anything," Robert said, a bit hurt.

"What should I have said?" she snapped, "_I just felt our son die inside of me_?" her whispers were hoarse as she pressed her head against the scratchy pillow of the procedure table, "God, Robert, I just want this to be over."

"I know, darling," he said, "It will be soon enough."

Dr. Bates stepped into the room, nodding somberly at Robert, then Cora, but she didn't look up.

"I'll administer a light sedative first," John said, reaching for a syringe. Isobel appeared next to him, looking expectantly at Robert.

"Is there anything I can do for _you, _Robert?" she asked, putting her hand on his upper arm, "In a few moments Cora will be blissfully unaware — but you will not."

He sighed, "I'm fine, Isobel. Though I would like to sit down."

She nodded, bringing a rolling chair across the room for him to wearily lower himself into. He leaned over to kiss Cora's temple as she drifted off, clutching his fingers weakly. He let his eyes flutter closed, trying not to overhear as Dr. Clarkson and Dr. Bates began to whisper to Isobel.

"_Start 10 IU pitocin." _

"_Lidocaine for the cervix." _

"_Tenaculum — if you would, there please. All right. Membranes ruptured. Fluid is clear." _

"_Isobel — position the ultrasound so that we can locate the lower extremities. The uterus is positioned — ah, all right. I see it." _

"_O2 sats are stable." _

"_Thank you. __Hern forceps?" _

"_And — uh —Metzenbaum scissors."_

"_Maintain tension on the cervix—traction, more traction, please. Okay. Shoulders are freed." _

"_Suction catheter?" _

"_BP is stable, pulse ox is fine — was a little low but it's back up." _

"_Good — All right. Well. . .let's deliver the placenta. 14 mm suction curette. Isobel, would you?" _

"_Yes, Dr. Clarkson." _

Robert looked up then, blinking out of his haze. He saw just a flash of something wrapped in sterile dressing. Isobel disappeared with it into the next room.

"Dr. Clarkson?" he whispered.

The older gentleman looked up, a bit startled, as though he'd been so focused he'd forgotten Robert was there at all.

"Yes, Robert?"

"Can Cora and I — can we be there when they spread the ashes? In the garden?"

"Of course." Dr. Clarkson said, dropping one of his tools into a waiting bin, "But Cora should go home to rest today. She'll be sore."

Robert nodded, reaching over and brushing the fringe back from Cora's forehead.

"We'll monitor her for a few hours in recovery. Just want to make sure she doesn't have any hemorrhaging and that her BP remains stable."

"All right," Robert said, nearly inaudibly.

After a moment, Dr. Clarkson stood up, nodding to Dr. Bates, "I'll have Isobel come back to help monitor her vitals. If you'll excuse me."

His steps felt weighted as he crossed the room; like Alice in Wonderland, it either seemed entirely large or _he_ was just suddenly quite small. He went into the hallway and quickly ducked into an empty procedure room. Isobel paused, heading back to the room across the hall, and looked at him fretfully.

"Are you okay?" she asked quietly. He noticed that her face was tear streaked, a bit of mascara smudged under each eye.

He nodded, unspeaking, and in one quick movement, turned away from her and retched painfully into the sink.

Δ

"Aren't these divine?" Charles said, popping another fresh raspberry into his mouth.

"Lovely," Elsie said, dropping a few into her palm, "Wherever did you find them this time of year?"

He shrugged, "I'm not at liberty to reveal my sources,"

Elsie grinned, tucking her feet beneath her as they sat in her den, the BBC crooning in the background. It was midmorning, and they had taken their coffee from the kitchen and enjoyed a lazy few hours chatting. Mostly they'd talked about Anna, the Crawleys — all of the heartbreaking happenings they seemed to be in the midst of. But as he'd brought fresh berries from her fridge, their hands grazing one another's as they both reached eagerly into the bowl, the conversation had shifted not forward — but backwards. To the past. Their past. The lives unlived.

"If you could go back — would you choose surgery again?" Elsie said, tucking the afghan he'd left on the couch around her ankles.

He nodded, swallowing his last mouthful of berries, "_Always_," reaching for another fistful, he raised his eyebrow, "What about you?"

She shrugged, "I think I'd have chosen obstetrics instead. I wanted to work with little ones, I knew that much — but I'd much rather bring them into the world rather than watch them leave it," she mused, sighing.

"I suppose even if you were an OB, you wouldn't necessarily avoid that," he sighed, pinching the bridge of his nose, "Poor Cora. I can't even begin to imagine the heartache."

"Losing a child — before you even get to _meet_ them," Elsie sighed, pressing her hand to her chest, letting her fingers curl around her clavicle, "They seem like a close family," she said, looking up at him, "You've known them a long time, mmm?"

Charles nodded, "Since Sybil was born anyway," he shrugged, "Cora was pregnant with her when Robert became Dean. That actually makes me feel rather old; I still remember when his _mother_ was Dean of Medicine."

"Oh," Elsie said, "Am I to assume she was the first woman to hold the position?"

He nodded, "The first and _only._ I think they've all been grooming Mary to succeed Robert, however. Thirty years ago — well, even _ten years ago_ to be honest — no one would have envisioned another woman to lead the institution. Violet was, frankly, the exception to the rule."

"Certainly times are changing," Elsie said, "If I'm not mistaken, just last _year_ female GP's outnumbered men in the UK."

"I suppose it will depend on whether or not Mary wants to raise a family," Charles said.

Elsie raised an eyebrow, "And why would _that_ make a difference?"

Charles blinked, "Well, she wouldn't want a job like that if she had children,"

"Her father's managed — as did her grandmother before her. As do _many _women, Dr. Carson."

"Well, Mary Crawley doesn't merely _manage_. She only thrives. She would not be content to be in a position to divide herself between two things at which she believes she can excel."

Elsie huffed, "Do you not believe her capable of _both_?"

Charles shrugged, raising his hands in surrender, "I've known Mary since she was a child; she's_ very_ specific in her aspirations. Stubborn, even. I don't think we live in a world where a woman can expect to have a job _like that _and be completely devoted to her family. Not with the hours required. The_ stress_ involved. Robert succeeded because Cora stayed at home with the girls."

"And was that a mutual decision? Didn't Cora have any aspirations beyond being a mother and a wife?"

"I — well," he furrowed his brow, "I admit, I don't know. I _assume_ she's university educated but. . .well, I couldn't tell you what her degree is in."

"You've known her for _years_," Elsie said, "Hadn't you ever asked her about herself?"

Charles flushed slightly, wiping his brow on the back of his hand, "Not really."

"What did you talk about?"

"The girls. Downton."

"Hm," Elsie said, "Well. What if _I'd_ been a mother?"

"Pardon?"

"If I'd had children of my own would you have treated me differently as a colleague?"

"What do you mean?" he stuttered, "Differently_ how_?"

Elsie shrugged, her mouth twisting in an irritated little grin, "Let's say I came to Downton—same as you remember—but after a few years I fell pregnant. Would you have thought less of me as a physician? Expected me to leave medicine?"

"I think that's too broad a question," he said pointedly, "What do you mean by _fell pregnant_?"

She snorted, "I should think you know what_ that's_ about, Dr. Carson,"

"Well yes," he snapped, "I get_ that_ much — what are the hypothetical circumstances? Certainly . . .I'd have treated you _differently._ Not unfairly, though. Wouldn't have wanted you to be in radiology uncovered or be exposed to anyone with rubella —"

"Yes, but beyond that. Would you have thought me a poor mother if I'd've come back to work? Not stayed at home to raise the bairns?"

He felt sweat pour down his back; somehow they'd gone from having a perfectly lovely conversation to a heated exchange about an alternate reality that wasn't even remotely possible. Clearly she was itching to make a point but he couldn't seem to grasp it.

"I don't know _what_ I'd've thought —" he said, his eyes widening, "I never meant for this to turn into an exercise in personal ethics. It would depend, like I said, on the circumstances."

"What do you mean?"

"Well," he huffed, "Like — well, who was the_ father_? Was he _around_? Was he — some bloke you met at a bar? Did you _marry_ him? Would he — help you? Did you have any support?"

She smirked, "Let's say that I did. _Marry him._"

"Alright. So you've married. You've had a baby."

_"Or two._"

"Or. . .two," he said, his brow knit together, "What does he do? What's his schedule like?"

She sat back against the couch cushions, biting her lip a moment.

"He's a doctor."

"Okay. . ." Charles said slowly, "Are you on opposite schedules? Or — well, do you have a nanny or something?"

She shrugged, "Let's say he was a _surgeon_."

He felt his breath rush out of his mouth in a loud sigh, "At the same hospital?"

"Yes," she said, her gaze unwavering. When she spoke, she leaned forward slightly, her voice low and deliberate, "If I had married, had a child — would you have thought less of me?"

He inhaled sharply, his chest nearly tearing at the harshness of the air, "It depends."

"On what?" she whispered, her eyes boring into his. He tried to steady his breath, exhaling as slowly and steadily as he could. Then, he leaned in so that they were both hovering over the coffee table, locked in a fierce gaze.

"On whether or not you were married to _me._"


	31. Oxytocin

**A/N: **Hi darlings! I know you've been patiently, patiently waiting, so I opted to give you a shorter chapter rather than make you wait for the entire chapter I had planned. I'll just divide them up! So, of course, that last glorious teaser actually represents the activity of the next _three or so chapters. _So, this hasn't got nearly as much angst as promised, which after the last chapter, is probably a welcomed reprieve. Thank you again for all your love for this fic. You guys are amazing and I'm so thankful for each and every one of you.

* * *

_He inhaled sharply, his chest nearly tearing at the harshness of the air, "It depends."_

"_On what?" she whispered, her eyes boring into his. He tried to steady his breath, exhaling as slowly and steadily as he could. Then, he leaned in so that they were both hovering over the coffee table, locked in a fierce gaze. _

"_On whether or not you were married to_ _me." _

A weighty silence filled the room, only broken when Elsie exhaled and a low, hollow hum filled her chest, resonating in the space between them. It was an agreeable sound, and Charles curled his uncertain mouth into a proud little sideways grin. Taking another deep breath, she exhaled again, smoothly — silently — and sat back against the couch cushions, widening the

emptiness between them. It was not, however, a sudden void. Something lived in that space, perhaps it had for a long time. And it had begun to awaken, springing to life on their unsteady breaths; reaching out and grasping for something to hold on to between their words. Living in the space of what went unsaid — a space growing narrower and narrower each moment.

"That still doesn't _exactly_ answer my question," she grinned, encouraging him, "How would you feel? _About me_?"

He cleared his throat, leaning back and shaking his head quickly, a bit flustered, "What — if — if we were _married_?"

"_Mhm_."

"And had — a child?"

"Or _children_," she said, biting her lip to keep from giggling.

"We'd have been . . . considerably _younger—_"

"—_presumably_."

"It'd've been up to _you_, really. Whether you wanted to stay home or keep working."

"Oh, I'd've kept on _working_," she sighed, her answer deliberate. He began to understand that while it may never have been a practical dream, she'd certainly thought about the logistics of marrying, having a family. More so than he had.

"I wouldn't begrudge you that."

Another moment passed between them and Charles looked up as she lowered her face. He heard a few sniffles in quick succession and realized she had begun to cry.

"Dr. Hughes —?"

"I'm being silly," she said, waving her hand dismissively, "Here we were having a perfectly nice conversation and I've gone and ruined it with my — silly little —"

He blinked, "What?"

"_Impossibilities_," she said, reaching up to delicately dust tears from her eyelashes.

"I'm not sure I'd categorize them as such," he said, his voice low. She looked up, paused, and then coughed slightly to cover up the fact that she'd not really stopped crying.

"Unless you've found a loophole in the space-time continuum, we can hardly go back and find out," she sighed, pulling the afghan up closer round her.

"Since we're speaking in hypotheticals— what if we _could_ go back? Would you have even gone on a date with me if I'd asked?"

She shrugged, "Oh, who could say? I was living with the blinders on, focused on my work. . ."

He felt a twinge of disappointment; the heat of humiliation burning his cheeks. Maybe he was wrong; maybe she_ didn't_ feel about how even a smidge the way he felt about her. Perhaps he'd merely been seeing what he'd _wanted_ to see. Feeling what he'd _wanted_ to feel.

_A sad, old fool, _he thought, his lips curling up bitterly.

"_Although_," she said, leaning toward him. He flicked his gaze up at her, saw how her eyes glinted and her face pinked up, the color high on her cheekbones, how she bit her lip in that pretty way that he wanted, so terribly much, to tell her he adored.

"Although?" he echoed, leaning in slightly himself.

"I've _changed_," she said, her eyes softening.

Relief washed over him, and in the moment that followed he could think of nothing to say except what he truly felt; simple and honest as it was.

"I'm _glad_."

* * *

"Can I get you some tea?" Robert asked, hovering awkwardly in the doorway to the master bedroom. Cora had lay down as soon as they'd come home and not moved since; but that was several hours ago. The late afternoon sun had crossed the span of their bedroom, illuminating her motionless form on the bed like a searchlight. She was breathing so shallowly she may as well have been holding her breath. Robert certainly was as he took a step closer to the bed, lowering himself onto it. He laid a hand on her hip, his fingers twitching uncertainly at the sensation of her silk pajamas. He was so terrified of hurting her. He only wanted to love her, to comfort her — to share in the grief that had been thrown over them like a net cast over a still sea, that he would have rathered suffered the absence of her touch than risk inflicting pain.

She didn't respond, and he ever-so gently leaned over her, searching her face. Her eyes were wide open, glassy, staring at the window. Her tear stained cheeks glistened as soft light poured unforgivingly into the room. There was nothing left to say, really, and even if there were, exhaustion overtook him suddenly and he lay back against the blankets, wrapping his arms around her and pulling her close to his body. He rested his chin on her shoulder, inhaling the sweet, soft scent of the perfume she wore behind her earlobes, and let his eyes close as she exhaled, the tension leaving her body at last.

* * *

The garden had been Violet's idea, oddly enough. Back when she was still a resident. Before she'd had any children of her own. She hadn't even intended for it to become a mass grave for products of conception, she'd just thought that the quad between the surgical units looked barren, and it ought to be brimming with life. When patients were lying in Med-Surg with nothing to do but stare out their windows, wouldn't it be nice for them to see — something?

_She'd spent a few weekends knee deep in the soil, pulling weeds and turning it so that something beautiful might grow there. It took a season, but soon little blossoms began to sprout up and she felt an odd sense of pride. For the first few years, it was nothing but a landscape job. But one day, when she had snuck away to her favorite bench to have a quiet moment and her tea, she saw a man standing by one of the tiny saplings they'd planted. His shoulders were shaking as he took something from his coat — a tiny tin. She stood quite suddenly and went to him, thinking perhaps he was going to litter; it almost looked like he was sprinkling tobacco leaves into the grass. _

"_Pardon me," she said, her heels sticking in the mud as she walked through the hedgerows to him, "May I ask what it is that you're doing?" _

_The man turned slowly, his eyes red-rimmed, tears glistening on the end of his nose. She stopped short, nearly toppling over as one her heels caught itself in the brambles. He exhaled, holding his free hand up as if to surrender. _

"_English — not good,__" he said, his thick slavic accent immediately apparent._

"_I would appreciate if you didn't — throw whatever it is you've got — into the garden. I planted almost all of these with my own fair hand," she said, making a fluid sweeping gesture with her hand across the expanse of the quad, "Surely you understand." _

_He let out a shuddered breath, recapping the tin, "Baby. Girl," he winched, struggling a bit through his tears and their language barrier. _

"_I don't quite understand," Violet said, letting her gaze dip to what the man held in his hand. It struck her almost immediately; it was not a tin, but an urn. Not leaves on the wind, but ashes. _

"_I go — to Soviet Union," he said. _

_Violet nodded, "Where — where is her mother?" _

"умерла_,*" he whispered, then, tapped his fingers lightly on the tin, urging Violet to understand._

"_Did she die as well?" Violet asked, "Dead?" _

_He thought a moment, then nodded. Violet considered him for a moment — how a young Soviet ended up at one of England's most elite medical institutions she couldn't say, but knowing about the war and fearing everything that it represented, everything that could possibly result from such intense conflict, she was overwhelmed by the feeling that she was witnessing what might be the only moment in this man's life where he could feel freely the grief that he was so near-bursting with. _

_She held out her hand to him, and when he didn't move, she slowly moved to lift the lid from the urn, gesturing again to the flowerbeds. _

"_Lay her to rest here," she said quietly, "We will watch over her. As will God." _

"_бог?" he asked, looking over his shoulder towards the hospital, scoffing a bit, "No God here." _

"_It's not for you, or I, to say where God may be," Violet said, though perhaps mostly unto herself, "Let her rest here."_

_She nodded again toward the flowerbeds, feeling her heartbeat quickening in her chest. This man didn't frighten her, and though they weren't communicating all that well verbally, it was almost as though they didn't need words. Grief was a universal language. She folded her hands neatly in front of her and took a step back, giving him some space. Then, she watched as he began to gently shake the ashes into the wind. When the urn was empty, he paused, recapped it, and turned to her, his eyes glistening._

"_спасибо," he said sincerely, locking eyes with her. Though she spoke no Russian, she felt his gratitude and bowed her head slightly. There was a moment's hesitation before either of them moved, but he did take one last look at the small tree, a near silent sigh escaping him, before he began to walk away from her. _

"_Wait!" Violet called, struggling back through the grass and dirt, her shoes now thoroughly ruined, to catch up with him on the dirt path, "What was her name? What were you going to call her? Your baby?" _

_He studied her face a moment, not understanding. She tried again, laying a hand on her chest,_

"_Violet," she said, then, pointed to him, her eyebrows raising inquisitively. _

"_Igor," he said, pressing his hand against his chest. _

_She nodded encouragingly, "And —?" she pointed at the urn, "Her name?" _

_He understood then, pressing the small urn against his chest, looking beyond Violet back at where they had just been standing together,_

"_Kira," he said softly. _

She often wondered, standing in that corner of the garden, whatever happened to Igor. He'd no doubt returned to the Soviet Union, but within a decade it had all but collapsed. Kira, had she lived, would be in her fifties now. Older than her father had been when Violet had met him. In the quad now, that sapling had turned into a mighty tree; a weeping willow, suitably so it seemed, and although Kira was the first, she was not the last to be laid to rest among the hollyhocks. Violet closed her eyes, thinking that at least if they never were destined to leave the hospital walls, to be carried on the wind or given back to the Earth was a far better fate than being marked as hazardous waste. And if nothing else, that gave her comfort.

* * *

"Serves you right, you know," Edith said, folding her arms across her middle as she stood in the doorway to Rosamund's bathroom. Her aunt was _more _than hungover; she was practically incapacitated.

"Oh, shut up," she said, her voice echoing from inside the toilet, where her head currently hung in shame. She retched, but it was a futile task. She'd really managed to be done being sick hours ago. Now she was just being punished.

"Even though you weren't exactly wrong, you shouldn't have spoken to grandmum like that, not in front of everyone. Not when we were all so sad."

"Edith, one day you'll understand — in every family there's that _one _person who is the Greek Chorus and says what's on everyone's bloody minds," she reached for the toilet tissue to wipe her mouth, "Though when it comes to you and your sisters, my money's on Sybil."

Rolling her eyes, Edith turned, heading back into Rosamund's bedroom to fix the blankets on her bed. She could have offered to wash her sweat-soaked sheets, but suddenly she didn't quite feel so generous.

Stumbling out of the bathroom, Rosamund collapsed onto her bed face down, seemingly unconcerned with the state of it, or herself, or anything else.

"I'll be going, then," Edith said, "I'm working the overnight tonight. Since you're entirely useless."

From the bed, Rosamund moaned, kicking her feet against the comforter like a tantruming child, "Don't be mean to me, luvvie, I feel dreadful. Aren't I being punished enough?"

"Not for my liking," Edith whispered, turning and heading out into the hallway. Before she left, she made sure to fill the ice cube tray, wipe down the counters, and make sure a few aspirin were laid out on the kitchen table.

She sat in her car for a moment, idling out front of Rosamund's townhouse. She didn't particularly want to go to work. She didn't particularly want to do, or think, or feel anything. But she wouldn't be useful if she went to her parents, she certainly wouldn't be useful trying to talk to Mary, she'd been as useful as she could to Rosamund — and now, short of going home and feeling truly useless alone in her flat, her only option was to go to work and hope that someone was having a worse day than she was.

* * *

Isobel rapped lightly on the door to Dr. Clarkson's office, which was ajar. She didn't exactly wait for him to respond, but pushed the door open so slowly that he had plenty of time to lift his face from his hands and attempt to regain his composure.

"Hello, Isobel," he said, "On your way home, I take it?"

"I wanted to check on you first," she said, taking a few tentative steps toward his desk, "You didn't seem well earlier."

"Oh. _Nerves_." he said, reaching into his breast pocket for a handkerchief to wipe his brow. She lowered herself into the chair across from him and studied his face a moment; it was so severely contorted into a grimace that she was afraid it might stay that way, "I did want to thank you properly for being there today, Isobel. I could not have done it without you. Nor could have the Crawleys,"

"I thank you for that, but I can assure you it was not _my_ presence that made the difference."

Dr. Clarkson furrowed his brow, which perplexed Isobel, because if she'd've been asked, she'd have thought it impossible for him to scowl anymore than he had been when she came in, "The Crawleys are very appreciative of you, Isobel."

"Not to say they aren't kind, they've always been as kind as can be but — well, I'm not one of them. I never have been."

"I'm not sure I understand what you mean," Dr. Clarkson said, "One of — ?"

"The Downton _elite_," she laughed, looking down at her hands to avoid his gaze, "You have an important seat on the board. You've known the Crawleys since their girls were just babies. They've certainly a nice rapport with Dr. Carson and Dr. Hughes but —" she sighed, "Well, I'm not one of them. And Sybil, dear girl, she'd like to shadow here. Us," she looked up at him then, giving a smile and a half-shrug, "_Me, _I suppose. And I just don't want her to . . .well, figure out how _ordinary_ I am. I suppose she's grown up hearing about her famous family, their friends. I'm just a nurse, doing my job, and a mother. I can't help but feel as though she'd be better off learning from someone more. . _.interesting._"

"The Crawleys think very highly of you, Isobel. In my experience, they care for you very much. But if it serves you to think yourself unloved, than nothing I say will make any difference."

Isobel blinked, unaccustomed to him being so curt, "I think that's — rather _harsh,_ Richard."

He merely shrugged, pressing his thumb and pointer finger against each side of his forehead at the temples, "It's been a long day, Isobel. We ought to go home."

"I was thinking of getting a drink. Perhaps you'd care to join me?"

He sighed, burying his face in his hands a moment, then looking at her from between his fingers.

"Fine. _One _drink."

"One drink," she said, standing and slinging her purse over her shoulder, "One _very strong _drink."

* * *

"I probably sound foolish saying it, but I'm sad to see you go," she said quietly, folding her arms across her middle. He smiled, shrugging into his overcoat.

"I admit, it has been a rather nice _furlough_ from everyday life. I suppose I wish it had all been under happier circumstances."

Elsie lowered her gaze, "I wonder what horrors await us when we return to Downton?"

"I suppose I'll find out tomorrow — were you thinking of coming in for a few hours?"

"Mhm," Elsie nodded, "Perhaps not a full shift. Though, I'm mending well. I've been very well cared for."

Charles blushed, "You should tell the press that; say what they may about Downton, they certainly _cannot_ say we don't have the best patient follow-up in all of the United Kingdom."

"Thank you, Dr. Carson," she said, "I . . .it would have been much more difficult had I not had your help. And the pleasure of your company."

He sighed, "It was my pleasure. I'm glad to help. And just so you know, you don't need to require sutures for me to come spend an evening reminiscing. If you'd. . .ever care for some company, all you need to do is give me a call."

She smiled, her eyes glinting, "Likewise."

He smiled back, then reached for his briefcase and small overnight bag, pausing slightly as he straightened his back, "Do you suppose — after all these years — we might call one another — by our first names?" he said, furrowing his brow, "I mean — unless you think it's weird—"

She bit her lip, then licked the bottom one, preparing his name, "_Charles,_" she purred, "Or, is it Charlie?"

He rolled his eyes, "It most certainly is _not _Charlie, and I'll revoke these proposed first-name-basis privileges if you utter it. . ._Elsie._"

The sound of her name in his deep baritone sent a shudder up her spine. She felt it, but wasn't sure if he'd seen it — though a little flicker of pride in his eyes told her that he certainly had. He took a few steps closer to her, his bag slung over his shoulder, briefcase in hand.

"I know it's been — rather an emotional few days," he said, his voice low, "And perhaps some things were said, some feelings shared — I want you to know that I was _entirely_ sincere."

"As was I," she whispered, looking up at him. They locked eyes for a moment, and then he took a step closer. She felt her eyes widen and then, presumably before he lost his nerve, he leaned down and kissed her tenderly on the cheek.

"You will call if you need anything in the night?" he said, shifting under the weight of his bag.

"I will," she said breathlessly, her entire body tingling. He nodded, then turned to her front door.

"Goodnight, Elsie," he said, smiling over his shoulder at her.

"Goodnight, Charles."

* * *

Mary pressed her cellphone hard against her ear, struggling to hear over the sound of a sudden, blaring overhead page. She ducked into an empty patient room just as Dr. Carson answered the phone.

"Yes?"

"Dr. Carson," she said, "I hope I haven't disturbed you. I know you haven't been in to work in a few days."

"No, no," he said, "I am in the car, however, so I'm talking to you on my headset. Apologies if it's a bit spotty."

"I won't keep you — I only hope that — well, will you be in tomorrow?"

"I plan to be," he said, and she could hear the vague sounds of traffic around him.

"Would you have a moment to speak with me?"

"I would," he said, "But may I inquire as to the subject of this proposed discussion? There're've been many a crisis in the last few weeks."

"Indeed there have been," she said, "I suppose I would like to touch on all of them. Mostly, though, I just . . .I feel that I owe you an apology."

"An apology?"

"Yes. I feel. . .that I have relied on your support for too long."

"_Mary,_"

"No, please. Let's not get into it now. I just. . .I _am_ an adult. I have made my _own_ decisions, and I need to respect your right to disapprove of them. And, in fact, you may be right in doing so."

Charles sighed, "Well, in any case — come to my office first thing. We'll have a chat about it."

"Thank you," she said, "Have a good night."

"Mary — how is your mum? And your father?"

"Not well. I would be lying to say anything else."

"Please give them my best."

"Of course."

"I'll see you tomorrow. Get some rest."

"You as well, Dr. Carson. Good night."

* * *

* Fun fact about Doc: I took Russian when I was in university, ha! I didn't remember very much though. . .so I definitely checked my translations. . .BIG THANK YOU TO GREEN DAME FOR REMINDING ME THAT THIS WORD NEEDED TO BE OF THE FEMININE GENDER-ING! :D


	32. Dyssomnia

**A/N: Hi darlings. So, this one has a pretty obvious theme! I know we've gotten away from a few plots, but they will all come back around, I promise! It was time to bring in our next patient — we get one for Edith, who deserves a good storyline, no? And of course when Dr. Hughes returns to work she'll need something to distract her from her boyyyyyfriiieeeennndddddd. Thank you again, and always, for your reviews here and on Tumblr. I so enjoy writing this story for all of you and I really look forward to posting a new chapter each week; it does feel like we're all sitting around for a new "episode" together! :)**

**Trigger warnings: Depression, overdose, suicide attempt, insomnia, anxiety, child abuse, miscarriage — I think that's everything! **

* * *

It was not uncommon for the big cases to come in just shy of when her shift was to be over, but on this particular early morning, Edith couldn't help but marvel at the timing: she'd nearly a half-hour before she could have gone home, it was just before six-thirty in the morning and it had been a relatively quiet night. This meant, of course, that she'd had plenty of time to think about everything that had befallen her family, and the hospital, over the last few weeks and the sound of the overheard page was as booming and commanding as God. She half-jogged to the emergency room in response to the call, and prepared herself for a few raised eyebrows; they'd be expecting Rosamund.

"Oh — good morning, Dr. Crawley," the emergency room doctor on the overnight shift was fairly new; a rotund, grimacing, often sweat-clad Dr. Spratt, "I take it you are on for Dr. Painswick?"

"Yes," Edith said, "I'm responding to the psych consult?"

He sighed somewhat dramatically, throwing up his hands in a somewhat effeminate manner as he walked down the hall away from her — she only assumed she was to follow, since he'd given no indication (as was typical of fast-moving ER doctors).

"The patient is a 17 year old female, polydrug overdose. We had a hell of a time stabilizing her; she meant business. Paracetamol and codeine— but get this — atenonol."

Edith blinked, "Where would she have acquired that?"

"It lowers blood pressure so, maybe a parent was taking it? This was a very methodical suicide attempt. I'd say this kid's a pre-med student. Either that or she really did her damn research. The paracetamol and codeine mix was easy to counter but we had to call Poison Control for the atenolol. She's going to be moved to the ICU shortly, but we wanted you to come do the psych paperwork before the new shift comes on."

"That's fine," Edith said, "Where is she now?"

"Trauma bay one, but you won't be able to get an admitting interview out of her, she's still unconscious." Dr. Spratt said, nodding toward the hallway behind them as he stifled a yawn, "You can have a look at her chart, though. I gotta say, your aunt's gonna be pissed she missed this one."

Edith grimaced slightly, then took her leave. She rounded the corner to the large, open room with the glass doors that was the first receiving space for incoming traumas. She didn't often find herself sitting in one, since the majority of her consults happened in the smaller, private rooms on the opposite end of the wing. She always felt her stomach knot as she slid her badge across the card-reader, always feeling slightly as though she were sneaking into a place that she had no right to be in.

Reaching for the paper chart as she stepped inside, she flipped to the admitting papers.

**PATIENT: APRIL GODDING**

**AGE: 17 YEARS**

**CHIEF COMPLAINT: POLYDRUG OVERDOSE**

**PRESENTATION: Patient is a caucasian female, aged seventeen, who was brought in via EMS post polydrug overdose. She had been found by a family member who was unable to rouse her, and made note of several empty bottles at patient bedside and a suicide note. Patient ingested several grams of unknown benzodiazepines, paracetamol and atenonol. Poison control was consulted and advised the administration of intravenous glucose to counteract the atenonol, which at its lowest point was 45/40 upon admission.**

**Psych has been called, patient will be transferred first to ICU for stabilization, under co-care of psychiatrist on call.**

Edith blinked a few times, then quietly closed the chart, moving slowly to the patient's bedside. The girl was pale, the skin of her neck nearly translucent. The monitors around her blipped and Edith found herself immediately looking for a blood pressuring reading. Stopping the arterial line, Edith's breath caught. This girl had nearly died. Flicking her eyes up to the monitor, she sighed. Her blood pressure reading was still low, blinking at 80/40, which while better than her admitting reading, was still a bit jarring. Edith sat down on the rolling stool next to the gurney, opening the chart again and flipping through the lab orders, the EMS notes. . .what was immediately clear was that this girl wanted to die. What Edith couldn't glean from it, but what she felt she must find out, was why.

* * *

Elsie had startled awake so many times in the night, that by 3 am she decided she might well be better off just getting out of bed and making herself a cup of tea. She sat in the darkened den long after the tea had gone cold, the photographs on the bookcase next to her continuously catching her eye in a way they hadn't in a long time.

She thought of her sister often; she _had_ to. Every _month_ she wrote a check. Every _day_ in the back of her mind, she was tuned in to the frequency of her sister's wellbeing. She'd slept uneasily, Becky's face, her mother's voice, bubbling up from her subconscious. It wasn't even that she was dreaming of them; she was remembering; and the truth was, at times, they were nightmarish than anything her exhausted mind could fabricate.

"_I won't do it, mam." Elsie cried, her hands gripping the doorframe as she stood in the middle of it, blocking the entrance to their washroom. It reminded her, for a moment, how the children at school had shown her how to make her arms float; standing in a doorway, pressing hands hard against the molding of the doorframe, waiting for gravity to play its tricks. Only now, she stood in a doorway not in jest, but in defense, and the last thing she wanted was for her arms to give out or rise up of their own volition. _

"_Elsie Hughes I swear to ever-loving God if ye don't get yer arse out of my way, I'll clock you square in the face," her mother snarled, struggling to wrangle Becky, who was halfway to the floor, kicking and nearly being dragged the length of the hallway. _

"_I won't let you," Elsie said firmly, "I won't!"_

_Her mother smiled, but it was a bitter, horrible smile, like a wolf showing it's teeth, "What do you expect me to do, reason with her? Don't be daft. Ye know as well as I that she'll kick us all blind and bloody black and blue if we don't—" _

"_Isn't there__ another way?" Elsie begged, digging her heels into the floorboards as her mother made her way down the hall, dragging Becky behind her, who had begun to scream. _

"_Ye know damn well there's not — now git out of my way!" _

_Elsie braced herself for the impact of her mother and flailing younger sister, but she was not adequately prepared to bear the brunt of anguished force. She toppled over backwards almost at once, her head just narrowly missing the side of clawfoot tub. _

"_Git up and help me — or git out," her mother snarled, kicking Elsie aside and hoisting Becky into the tub. The screaming only escalated, and Elsie struggled to get up, trying to reach a hand up for Becky. _

"_It'll be okay —" she said, her soothing words lost in the cacophony of wails and her mother's cursing, which grew louder as she tried to hold Becky down._

"_Hold her arm, Elsie," her mother pleaded. Elsie hesitated, but when she realized what was imminent, she reasoned it would be better to stay and keep a watchful eye on her sister as she endured her torment, rather than walk away and turn a blind one._

"_Becky, luv, it'll be over soon, I promise ye," Elsie whispered, reaching up to stroke her sister's hair, jerking it away suddenly as Becky turned her head, primed to bite down on her hand. _

"_She's worse than a bloody rabid dog when she's like this," her mother muttered, blowing a wisp of hair from her face, "I'd half a mind to take her out back and —" _

"_Mam," Elsie cried, "Don't say that, don't even think that!" _

"_Don't tell me what to think," her mother screamed, her hair falling limply across her face, "God forbid you ever get up t' duff — bairns will ruin you, Elsie. They'll ruin everything for you. Do you think I wanted this life? Do you think that I want to sit here holdin' her down like an animal? Do you think I want to do this? Let this be a lesson to ye: no bairns. Better yet, no men." she laughed bitterly, "Have ye ever seen! yer father doin' this? Have ye ever seen him look at her unless it was to kick her across the room? Look at me — Elsie, LOOK at me. As long as I live, Becky's my cross to bear — but when I die, she'll be yours. So until the day when it's ye holdin' her down and pouring frigid water over her head, don't be tellin' me what to say or not say — do ye hear me?" _

_With that, she reached up to turn on the spigot, a blast of water starling all three of them. The pipes in their old farmhouse groaned to life and in one quick motion, Elsie's mother pushed Becky down, under the stream, and held her there._

"_Elsie — hold her legs!" _

"_Mam, don't—" _

"_Do it, or git OUT!" _

_Elsie began to cry, helplessly; hopelessly, and placed her hands gently on her sister's kicking legs. It only took a moment for the icy water to settle her into submission. Her mother reached up, turned off the spigot and sat back on her heels, wiping her hands on her apron. Becky blinked up her, soaking wet and stunned. Her mother stood up, and, as if she couldn't stand to look at her another moment, quickly left, slamming the bathroom door behind her. _

_Elsie reached down and lifted Becky from the tub, cradling her against her shoulder like she had when she was a wee bairn. She wasn't that much older; Becky had only just turned ten, and in just a few weeks, Elsie would be twelve. Still, Becky was so small for her age that she was easy to lift, and she liked to be held. _

_Setting her down gently in the middle of the washroom floor, Elsie looked around for a towel. She grabbed two from the linen cabinet below the sink and wrapped them each around Becky, squeezing her tightly to her chest. _

Shaking her head to rid herself of the memory, Elsie reached up to wipe the tears that had fallen onto her cheeks. She closed her eyes tightly, trying to squelch Becky's cries.

Her conversation with Dr. Carson — _Charles, oh good Lord _— had been nothing but folly. What good did it do her to remember what had happened, let alone what never had — what never would? How brazen she'd been to tease him, to even utter the word _children _in his presence. She'd not've married him, not've had his baby — and oh, _if she had?_

What would he think of her, holding their little tawny-haired child down in an ice bath when they'd misbehaved? What would he think of her, cursing the changes in her body — screaming in agony, in hatred, in echoes of her mother's admonishing — trying to bring the bairn into the world in the first place? She'd've been a wretched, terrible, cruel mother. She'd've been a frustrated, desperate, terrified mother. She could never trust herself _not_ to do as her mother had done; no amount of education could teach what life failed to. Becky had been better off without her, it didn't matter that she loved her and worried over her — Becky was perpetually a child and she terrified Elsie. The push-pull of wanting to care for her, part of her believing that because she always _did_, it meant that she _could—_ but also remembering how she was an accomplice to Becky's pain and punishments, how she abandoned her and went to England for a better life. She'd meant for both of them — _hadn't she_?

And she knew as well as any physician that Becky's traits were likely genetic — what if she'd had a child just like her? Why would Charles ever want to bring a child into the world with _her, _knowing full well that the possibility of bearing Becky all over again was, perhaps, their fate?

She'd only had _one_ scare in her entire life; an on-call room rendezvous with a nameless hospitalist, someone who came and went in the few passes of day into night. She was in her late thirties, had been at Downton nearly a decade, and while she wasn't daft enough to think that she'd already started menopause, between her cycle's irregularity from stress, her tendency to drop weight when she was emotionally wrought and being forced to subsist on whatever she could scrounge up for food between patients, missed periods weren't surprising. She hadn't even considered the possibility that she might get pregnant; she'd been careful — she always was, _neurotically so_.

But still, weeks went by, turning into months, and by the change of the seasons she'd felt her body begin to soften. She'd not had her period in _much _longer than she could remember having skipped. Her body felt tender, her emotions a thread easily tugged at, pulled taut and snapped. Of course reason told her that there was a possibility — _always a possibility_ — that she'd gotten pregnant. But she couldn't bring herself to take a test.

One very early morning, after she'd fitfully slept in an on-call room, dreams of her baby sister, of Joe Burns — of the children on her ward — keeping her from rest, she snuck out into the supply closet and dug around for the kits. Pocketing one, she strode sleepily through the corridors to the lockers — rounding the corner and running directly into Dr. Carson, who was exiting, changed from his scrubs and on his way home after a long shift, she reckoned.

_He stood so tall above her that she had to crane her neck to look up at his eyes when they were standing this close. He was in his civvies: dark jeans, Polo shirt and a jacket. His bag was slung over his shoulder and as she lowered her gaze, she saw that he had flat-soled trainers on and for some reason she found that to be entirely in opposition to what she had come to know of his personality. _

"_Sorry," he laughed, "I'm half asleep — as I'm sure you are. Headed home?" _

_She blinked up at him, "Ahm — yes. Soon. Just, ah, going to get changed." _

"_Well, I'll leave you to it. See you later." he said, giving her a small wave. _

_She waited until he'd disappeared down the hall, her heart still oddly joyful at his squeaking shoes on the linoleum, and pushed into the locker room. Thankfully empty, she tucked herself into a stall and dug the kit out of her pocket. She'd seen them so many times but never had to wrangle one herself. It made her feel peculiarly girlish; as though she were back in school getting caught smoking with the sixth year girls. She sighed, shaking the test from its packaging and squinting at it curiously. What an odd thing to do, she thought, then waited what seemed like an agonizingly long time for it to result. _

_Negative. _

_Relief washed over her but something else — the hollow and loudly echoing feeling of being alone in the world. _

Riddled with guilt, she reached for the afghan on the back of the couch and wrapped it doubly tight around herself, sinking into the cushions in falling back into a fitful, chilled sleep.

* * *

Charles hadn't slept, his mind and heart were in a race and he wondered momentarily if he might be having a minor heart attack. He'd never felt his body burn all over this way before. A pleasant if not slightly painful tingling, an adrenaline rush that was akin to surgery, yet deeper and subtly more gratifying. He lay in bed, in his darkened bedroom, and it suddenly felt unfamiliar to him. He'd been in this flat for so many years he ceased to see it anymore; but a few days away had made him more aware.

He lived such a pristine life, and while he generally hated messiness, he suddenly missed the disarray of objects that came along with Elsie Hughes. He'd've tolerated — even _liked_ — to see her shoes strewn about the floor, her jumpers draped over the chair in the kitchen, her lipsticks lining his bathroom sink. He closed his eyes and relaxed into his pillow, trying to imagine what it would have been like to be with her when they had been young — so young, so full of ambition and excitement for their work, for_ each othe_r. It electrified him to imagine that time in his life. He'd been a rather handsome young doctor, bright and eager. Hardworking. She, too, had been among the best that Downton had to offer, and it was only natural they struck up a friendship.

He would have proposed with his mother's ring — maybe it was terribly _saccharine_ a thing to do. Maybe she'd've hated it. But truth be told, the ring was too beautiful not to offer up at least; he thought, perhaps, she'd even like it since it was delicate and wouldn't draw too much attention. Rose gold with a single diamond set among intricate designs. Knots that could almost be Celtic if you squinted.

They'd've had a small wedding. Maybe no wedding at all, just a visit to the registrar. Their parents were gone, no family, few friends at Downton and no one else. They'd have taken a holiday somewhere warm; Spain, maybe. Shared a flat close to the hospital. Triedto plan children straight away to time with their changing residencies and schedules.

Maybe they'd only have managed one, but that would have been alright. _He_ was an only child and he'd turned out fine. He'd have marveled, of course, at everything. Wondered if he'd've recognized the change in her, sensed it as they lay in bed together, hands clasped tight. And he almost believed that of the two of them, he would have been more fraught with fear for what could go wrong.

In so many ways, she was the more rational doctor. He looked for zebras when he heard horses, but she could have been on a safari and insisted that hoofbeats in the distance were stallions. He would have watched in mixed awe and worry as she walked through life as a chrysalis those nine months, his heart leaping wildly at every thump inside her, every ornate receiving blanket she would fold and tuck neatly into a small white dresser, every belabored sigh she heaved until — at last — the baby was born.

It was not as though he had little to no experience with infants, children. He'd done a pediatric rotation. Certainly had his fair share of pediatric surgeries over the years. His gentle spirit was always at odds, however, with his stature. He believed that _had_ he been a father, he would have needed to make a concerted effort to temper his presence in the world. To soften his booming voice, his strapping hands, make himself into something lovable and _loving_.

Truth be told, he'd have been the softer parent, he was almost certain of it. She was far more innately managerial when it came to people and he would have been far more likely to give in to the wiles of a child's wide-eyes, especially if they'd've had a little girl. If caring deeply for Mary Crawley over the years had taught him anything, though, it was that there were trials and tribulations to be had even then; perhaps more so, and they were all the more striking when you really, wholly loved a person.

He'd want to take them both on holidays — Paris, Berlin — tour the museums, teach his child about everything — as to not pigeonhole them into only certain familiar interests. He suspected he would learn two fold through teaching a child, and perhaps —that could _also_ be true of loving them.

Had they managed this incredible feat together, this legacy of love, then now, at their extended ages, they would not be sleeping alone in their respective flats halfway across town. They would be cozied up warm, content and finding place in one another's company. Elsie would not have faced surgery with such fear; she'd've had him without the angst of asking, had grown children to stay with her even.

Perhaps even grandchildren by now.

It was a nice, if not slightly sobering thought to have as he lay there, the fading memory of her scent hovering on his nightclothes as he finally, blissfully, drifted off to sleep.

* * *

_Rosamund sat on the edge of their bed, her back to him. After a moment, she felt his warm hands snaking around her hips, gently tugging at her. _

"_Rozzie, come on," Duke said, pulling himself across the midline of the bed. He planted a kiss on her lower back; she could feel the heat of his mouth through the silk of her nightgown, "It's okay, we'll keep trying. . ." _

_She huffed, the tears she'd been trying to quell falling fast now that the dam had broken, "We've been trying for years, Duke, it's not going to happen. There's something wrong with me, that's all there is to it." _

"_It might be _my_ fault — why are you so determined to blame yourself?" _

"_I don't know — I guess it just seems like it's always the woman's fault." She turned, looking over her shoulder at him. He looked absurd, smiling up at her from the base of her spine. She reached behind her back and steadied herself, turning toward him, pulling her legs up onto the bed. She sat cross legged, settling his head comfortably in her lap. She let her hand rest against his hair, stroking it as one might a cat's fur. _

"_It's probably a self-fulfilling prophecy," Rosamund said quietly, staring out the window of their bedroom into the velvet night, "I was always terrified to be a mother. Terrified of being _my_ mother. Maybe that's a fate I never could have avoided. Maybe my body is just rejecting this fate in order to protect me from inevitable failure. . ." _

"_I don't think that's how uteruses work, darling," Duke said, "But, then again _I'm_ not a doctor." _

_Rosamund offered him a small smile, "I thought I knew — but I guess not," _

_Duke turned his head, nuzzling her middle. After a moment they both sighed deeply, Rosamund giggled slightly at the synchronicity. _

"_It was really always up to you," Duke said, his voice muffled against her. He pulled his face back, shaking hair from his eyes as he gazed up at her, "I would have been fine with or without. I will be fine — with or without — children. All I need, or want, is _you_." _

"_Are you sure you're not too disappointed in me? Wouldn't you have wanted someone to carry on your name?" _

_Duke shrugged, "I don't think like your family, Rozzie. You know those things don't matter to me," _

_Leaning down to kiss him, Rosamund laughed against his mouth, "One of the many reasons I love you, darling."_

"_Is this going to tear you up, though?" Duke said, "Were you really set on being a mum?" _

_Rosamund leaned back, pressing the palm of one hand against the bed to steady herself, "I suspect it's probably better this way. Besides, we've got niecelings. Bobby's little girlies. They'll keep us busy." _

_Duke yawned, "Little Edith's taken a real shine to you." _

_Rosamund grinned, "I think she feels a little ignored. Between Mary's precocity and Sybil—" she laughed, "—being perhaps the most adorable toddler anyone's ever clapped their eyes on, I suppose she feels that no one notices her." _

"_But you do," _

_Rosamund shrugged, "She's my girl," _

"_Well, maybe you've got to look out for her. Maybe that's why we can't seem to have one of our own. You've gotta be her champion." _

"_Maybe," Rosamund said, "I only hope I don't fail her." _

* * *

The longer Robert lay in bed, staring at the ceiling, the more convinced he became that his insomnia would ruin what little sleep Cora was getting. Trying not to disrupt her, he slid out of bed and padded out into the hallway. It occurred to him as he stood at the top of the stairs that he didn't know exactly what it was he planned to _do_ now that he was awake. He wasn't hungry, but a cup of tea wouldn't go awry.

Since the girls had all grown up and gone away to uni, the house had become uncomfortably quiet. Of course, he never mentioned it. Cora was wont to; often she'd be standing in the kitchen, chopping vegetables, and she'd sigh and say, _"It's so quiet. . ."_ at which point all Robert could do was agree. It _was_ quiet, and it wasn't the absence of the girls that made it so, it was who they were in the absence of children.

Putting the kettle on, Robert slunk into the den. Without much thought, almost as if he was on some kind of nostalgic, midnight autopilot, he stumbled about in the dark for a moment to find the bookshelf that held their VHS tapes. He'd meant to get them all transferred onto HD DVDs, but whenever would he have the time to find someone to do it? Perhaps now. _Now_ he would have the time. He'd _make_ the time; it would be a marvelous anniversary present.

He shook the VHS from its paper case and popped it into the VCR, groping for the remote so that he could turn the volume down low. Sitting down on the floor, in front of the telly, he waited as the grainy picture cleared; by some miracle, the tape had started at the beginning, as opposed to somewhere in the midst of a memory, _disorientingly so,_ as it usually did. He silently praised whoever had remembered to rewind them.

"_What are you going to film?" _

Robert looked up at the screen and, for a moment, he could have sworn it was Sybil staring down at him. In fact, it was Cora — but so young. How he remembered her in his mind's eye, in his heart. Her face was fuller, hair longer and without any gray. Her eyes were always wide and sparkling, and she had a little sideways smile that he adored; one that she was giving the camera.

"_I'm recording something I never want to forget," _

He heard his own voice then; younger, less hoarse — dare he even say, boyish?

"_And what, pray tell, might that be?" _

_He watched her through the viewfinder; her hands on her hips, her eyes asking. He struggled to pan the camera out, so that he could see her from head to toe. He wanted to remember her, to remember them both — like this. Forever. _

"_You, darling," he said, setting the camera down but letting it run._

Robert laughed; he'd watched this a million times but he always was so pleased by his carelessness in not turning off the camera, as it lay silent witness to their youthful love, he had captured them for who he knew they truly were.

Even after work, and the girls, and everything that was happening now — he wanted to believe that deep down inside of them both were two crazy kids in love. Two twenty-somethings in a tiny flat in London, where she would dry her bras on the radiator and he would study medical terminology while she painted, acrylics spattering their wood floors.

The tape leaped then, buzzing and snapping, until it clicked forward in time. Robert's breath caught hard in his throat, a painful, unmovable lump. He _almost_ reached forward to fast-forward. He _almost_ closed his eyes — but he couldn't tear his gaze away from her.

He couldn't allow what they had lost to tarnish the memory of what they had been blessed with.

_Mary Josephine_ had come first — and he felt himself begin to cry as he watched, as he remembered, that hospital room where he first met her. He watched a nurse clad in white lean down and hand Cora the tiniest bundle. He watched himself, a young man even then with a full head of hair and the shiny, rosy face of a terrified new father.

"_Bobby, she's beautiful," _came the voice from behind the lens: Ros_. O__h, thank you Ros_, he thought, for making this memory one that he could relive — even when it was a salve. Even when it was a stich in an open wound.

"Dad?"

He startled, squinting into the darkness.

"Sybbie, darling," he said, reaching up to wipe his face, "What are you doing up?"

She shrugged, walking across the room and settling in next to him on the floor, leaning her head against his shoulder, "I could ask you the same question, but we both know the answer."

Robert sighed, pulling her closer and kissing the top of her head, "I was just dredging up some old memories. Salt in the wound, maybe. Thinking about you girls when you were babies."

"Which one of us is that?" Sybil said, nodding toward the telly, "Oh my God, look at your _hair_."

Robert chuckled, "I know, I know. Between your sisters, your aunt and your grandmother half was gone before you were even born."

"That's Mary, then?"

"Mhm. She was . . ." he sighed, "_Early,_ of course. Had to make an entrance, and did she ever. We practically didn't _make_ it. Though, I think it was partially because your mother was convinced it was just Braxton Hicks right up until her water broke — and even _then_ she shooed me away, saying she'd merely wet herself."

"Was she in denial?"

"No, no," Robert laughed, "She was just convinced that she'd '_know'_ when it was the real thing. And trust me, once her water broke and her labor progressed in earnest, then she knew."

"Nothing went wrong, though? Not like with me?"

Robert started to shake his head — then laughed, "Well, she was born very fast for a first baby. Edith though. . .well by that time your mum was rather expert at knowing when we should make for the hospital. So, at least the doctor had time to put his gloves on with her."

"_Ew_ —"

"Don't tell your sisters but — well, Mary was born so fast, so quickly after we got there, that the doctor didn't have time to throw a gown on, or _gloves_ even — actually, I think he might have had _one. _Anyway, so Mary did have a very minor staph infection on her face. Looked like baby acne, actually—"

"_Oh my God._ Well,_ that's _brightened my spirits. Mary was an ugly baby?"

"Well, she wasn't _ugly_," Robert scoffed, "But —_ erm_ — she had a few blemishes in the beginning."

"What about Edith?"

Robert sighed, "As in life, Edith was rather . . _.reserved_ about the whole thing. Actually, your mum and I were both a little frightened, because she popped out and — _nothing._ No cries. No wiggling about. She was fine, actually, completely fine — just quiet. Of course, once they started hoovering her up and doing all their tests she whined — but she didn't scream like you and Mary did."

"No, Edith's never been much of a banshee," Sybil said. She quieted, lifting her eyes to the screen again. She and Robert sat there in comfortable silence, watching as the scenes and seasons changed — Mary grew taller, Edith toddled along. And then, frustrated, heavily pregnant Cora chasing after two toddlers.

"It's so weird that — that she was_ just_ pregnant and now she's_ not_," Sybil said quietly, "I mean, Mary and Edith probably remember when she was pregnant with me — but I never got to eagerly await a little brother or sister. It was. . .I don't know, it was kind of special and I think mum thought so too, you know? But now I just. . ." her voice trailed off and she tugged on Robert's robe, using the terrycloth to dry her eyes.

"I know. It is strange. Of course it was my fourth go-round but — it _was_ different. Everything about it was different. And. . .maybe that was why it wasn't meant to be."

"Is she going to be okay?"

"Eventually," Robert said quietly, "Your mother is . . .the strongest woman I know," he rested his chin on top of Sybil's head, hugging her tighter, "_You_, my dear, are the second."

* * *

Cora was torn between wanting, desperately, to be close to Robert — and being flooded with relief by his cold absence in the bed as she stirred awake again. Her body was playing tricks on her; flutters of a baby no longer there kept her awake and when she did, finally, drift off into blissful unconsciousness, she would be jarred back into reality by a phantom thump.

She mewled in frustration, burying her head under the pillow. Her body was still reeling from the procedure, aching and bleeding, and all she wanted was the kind of sleep that only drugs could afford her. She didn't want to take any heavy sedatives, though she knew there were some in the cabinet. She found herself distrustful of her heart; what would stop her from taking the entire bottle — not even to die, just to sleep uninterrupted, to stop feeling _everything, _to find enough peace to bolster her for the days to come.

The years still left to go.

Futile though it may have been, she closed her eyes tightly, tucking her hands under the pillow and willing herself to think of nothing; just the satisfying void.

But all at once it was filled with images, and feelings, and memories — she was already a mother, this baby who wasn't to be would not have made her so. She'd been so blessed; three healthy baby girls born to her. She'd experienced each moment with them, loved them from their seedling beginnings, felt them grow and tumble inside of her, brought them into the world with nothing but her own strength and Robert's love.

And suddenly it didn't feel like _enough, _her hazy memories of delivery rooms seemed to have lost some meaning in her current failings. She tried desperately to find the joy in the memory of nursing Mary for the first time, a little success shared between them in a dimly lit hospital room. She tried to recall those first steps, first words — first _I love you mummy_ (which fell so freely from Sybil's mouth, and she had been the only one to say "_Mummy_" first; for Edith, it had been "_Dada_", and Mary — simply "_No_" — and when she did learn Mummy, it was always with the modifier, "_No, mummy_," — which perhaps set the tone for their relationship, if words could.)

Robert had always maintained that Cora had been so natural with Sybil because, by that time, she'd made all the mistakes as a mother as she possibly could with the older girls. Cora knew it was deeper than that, though. She would never propose that she had a _favorite, _how could anyone have a _favorite _child? But she couldn't deny that she just loved Sybil differently. Not that she loved her more, exactly, she just felt like Sybil had, from the moment of her birth, spoken to a different part of Cora's heart.

Maybe it was the American part, she couldn't say. She just knew that she looked at Mary and Edith and saw the Crawley's history on their faces; especially in Mary. Sybil's bright face, however, was a portal into the future. Looking into her large, inquisitive blue eyes for the first time, all Cora saw was promise.

She'd certainly never relayed any of this to Robert; but now, laying awake in bed, pressing her hand against her uninhabited belly, she cried openly, wondering about the son she'd never know; who would be perpetual possibility.


	33. Prodrome

**A/N: **HELLO! Here is a teensy, tiny, baby, funsize, mini, teaser chapter for you! I'm sorry I've not updated. I'm getting carried away with the other fic, and, this new plot of Edith's _plus the mess with Green, _has me trying to pace correctly so as to not overwhelm you too much! :)

* * *

Despite very little sleep, Elsie did wake feeling a bit better. Her incisions were clean, far less sore and she actually felt very much like getting dressed and going to work. But first, coffee. And something from the patisserie. She still didn't feel like cooking, and now that Dr. Carson — _Charles, _she whispered, his name a smile on her lips — had gone back to his, she'd no one to make her breakfast.

Although she was up and about, no one would be expecting her until mid-morning, so she had time to take a short walk through her neighborhood to the little bakery on the corner. The fresh air would do her good, and it was a relatively dry morning from what she could see out her bedroom window. Chilly — probably even cold (at the end of October as it were) — so she'd throw on a wool sweater, toss her hair up in a clip. The promise of something warm to drink, to hold between her hands, motivated her out of her flat and down the stairs (slowly, still, but more confidently than the day before) and out onto the cobblestones.

The neighborhood was quiet, as it was every morning when she left for work. Rarely did she run into any neighbors, though she knew there were a few; older ladies with dogs. Widows, most likely. She buried her chin in the fabric of her scarf and heavily collared coat; it wasn't too cold but there was enough of a nip in the air that she felt a bit shivery. For a moment she was reminded of that night, with Charles, how he'd fallen asleep in bed with her. She was glad her mouth was obscured, lest anyone spot the tiniest smile she allowed herself.

She approached the end of the second block and noticed a rather large crowd had gathered out front of one of the offices that lined the streets. As she approached, she heard murmurings from the throng of people.

"_He's the best attorney in England," _

"_He'll take Downton for all their worth," _

"_Hope that girl has lawyered up," _

Her breath hitched and she stopped short. Behind her, someone cursed, _jesus christ, lady, watch where you're going!_

She took a few hesitant steps into the crowd—turning to the first person who wasn't already tittering to someone— and inquired about what the fuss was.

"Alex Green's just gone in. He had a bunch of reporters chasing him down but he turned around and gave 'em a _megawatt_ smile. Looked like he'd just stepped out of a fuckin' Armani advertisement, too."

Elsie was thankful that she'd not yet had a proper breakfast, because her stomach lurched so violently that she was certain she'd've vomited.

"Look — there he is, having his coffee. Waiting for his attorney, I think," the woman squinted,"Oh — _huh_, looks like he's going to find the loo . . ." as he disappeared from view, "Well, that's enough drama for one morning. . ."

With that, the crowd began to dissipate. She remained in the center, people jostling her as the sea of faces moved toward and beyond her. When they'd gone, she took a step closer to the window, peering into the office through the slightly tinted glass. She watched as the office's secretary, a tall lanky blonde in a well-tailored suit, stood, smoothed her skirt, and disappeared into a room behind her desk. Then, Alex Green returned from wherever he'd gotten off too, settling back down into his seat. Waiting.

_Preying._

Something came over her then. She pulled on the door so hard that a shot of pain rang out through her chest, her breast, but she didn't care. As she rounded the corner into the waiting room, she huffed, her panic starving her of air. He looked up slowly, giving her a sly grin.

"Hello," he said, "Lovely morning— isn't it?"

* * *

"Good morning," Charles sang, wandering through pedes with a takeaway coffee cup in each hand, "How are you ladies?"

Beryl looked up at him from over top her reading glasses, her lip curling up uncertainly.

"That you, Dr. Carson?" she said, squinting, "Normally I'd ask if you'd a bug in your arse, but if you do this morning it must be a damn happy one,"

Charles sputtered, "I'm — just trying to make pleasant conversation," he said, his cheeks flushing, "Dr. Hughes is coming back today. For a few hours at least."

"By your excitement you'd think she'd been gone a _fortnight,_" Beryl scoffed, eyeing Daisy, who buried her nose further in a chart she was working on.

"Oh — good morning, Dr. Carson,"

He turned, seeing Anna coming down the hallway, her knapsack slung over her shoulder. She'd not yet changed into her scrubs and her hair was in a messy bun, "I didn't think I'd see you for a few more days at least. How is our patient?"

He smiled, "Much better, I think. Hoping to grace us with her presence today,"

Beryl gave Anna a look from behind Charles' back, and she had to press her lips together firmly to keep from allowing a giggle to escape her.

"And how . . . are _you_ Anna?" he said, a bit quieter.

"I'm fine," Anna said, smiling stiffly, "But if I don't get changed, I'll be late for my shift," and with that, she wiggled by him and carried on down the hall toward the lockers. Sighing, he turned back to Beryl, who was still eyeing him skeptically.

"Well. . .I'll just . . . go on down to her office then. Carry on," he said, whistling as he headed off down the hallway away from the nurses' station.

"Do my eyes deceive me or is he _aglow_ this morning, Daisy?"

Daisy blinked, "I — I don't know. He seems. . . chuffed."

"_Highly_ _suspicious,_" she scoffed, suddenly typing something furiously into her laptop, "If I didn't know better I'd say he gave our Dr. Hughes a _Marvin Gaye_ kind of healing. . ."

"I don't know what that means. . ." Daisy said, though she wasn't sure she ought to be encourage Beryl to expound.

She needn't have asked further, because in a half-second, _Sexual Healing _blared from her computer speakers, startling them both. Over the sound of it, and Beryl's wild knee-slapping cackles, they didn't hear the pounding of footsteps racing down the hall toward them.

* * *

"You're from Downton, aren't you?" Green said, resting his hands languidly atop his head, leaning back in the chair he was seated in, "I believe we met at the Gala — though I hardly can put a face to a name now, after that night . . got _quite_ a knock on the head," he bared all his teeth, challenging her, "You doctors sure know how to throw a party,"

Elsie felt hate rise like bile in her throat and she took a deliberate step toward him, "I know who you are. And I _know_ what you've done." she hissed, "And if you value your life, you'll drop the act and keep the shadows."

Green raised an eyebrow incredulously. Before either could speak again, the secretary came around the corner.

"Mr. Green? Mr. Vyner will see you now."

Unruffled, Green stood, taking a swaggering step toward Elsie. She wanted to bolt, to run from him, but she dug her heels into the ground and kept her eyes on him.

"A _pleasure_ to see you again," he said extending his hand — his face, the closer he got to her, she could see was wild with agitation. Trying to suss her out, size up her threat. "But I'm sorry; I didn't catch your name?"

"I didn't throw it out for you to _catch_," Elsie huffed, staring up at him, "The only thing you'd best hope someone throws out for you is a life preserver, Mr. Green. Because if Downton goes under — I promise — _you_ will go down with it."


	34. Panic

**A/N: **Hello my loves! Well, we're back sort of? Thank you for continuing to love this story. It loves you too, really~ :) I'm the luckiest ficcer in the whole wide world.

* * *

"Spratt was right," Rosamund said, dropping the chart on her desk with a huff, "I _am _pissed that I wasn't here for that admit,"

Edith furrowed her brow, bending self-consciously over the muffin she was nibbling on as she sat in Rosamund's office, "Was I wrong to admit her—?"

Rosamund balked, her takeaway cup of coffee halfway to her lips, "_No, no_, not that — I'm pissed I wasn't here for it is all. Not every day that old goat Spratt doesn't have an answer for something. I'd've liked to have seen him grousing about having to call Poison Control because he didn't know how to counteract the atenonol."

Smiling as she took a bite of her breakfast, Edith shrugged her shoulders slightly, "But you agree with my decision to admit how I did?"

Rosamund nodded, "Of course — psych won't take her until she's medically stable."

"Have you had a chance to see her yet?"

"Edith," Rosamund laughed, "I haven't even finished my coffee _yet_."

"I know," she said, trying not to sound too eager, "I'm just. . .anxious to hear what you have to say."

Rosamund frowned, "You make it sound as though you suspect this is something other than what the chart implies—" she flipped open the manilla folder, "— a suicidal teenager."

"I've got a feeling is all,"

"Why?"

"The atenonol, for one. Dr. Spratt said she'd've had to do her research."

"Or she just cleaned out the medicine cabinet at Grandma's," Rosamund snorted, "I'm not trying to minimize her situation — adolescent depression, suicide even, is _rampant_. And we've got to get better about diagnosing and treating it," she sighed, "But don't go looking for zebras—"

"I know," Edith said, "And I'm not — I just —" she sighed wearily, "I don't know."

"Don't get into the trap of identifying with them," Rosamund warned, "You were seventeen once. Flailing in your older sister's shadow. Unnoticed by boys, by your teachers, by your own parents," she leaned across the table, "I _know _you, Edith, I know where you've come from. I know that you've gone to that dark place and come back. But you have to keep your clinical detachment. Especially on cases like these."

"I know," Edith said quietly, "You'll go see her this morning though?"

"Yes," Rosamund said, "Besides, she's in the pediatric ICU and word on the street is that Dr. Hughes and Dr. Carson have returned from their . . ._holiday._"

"They weren't on holiday, she had surgery," Edith said, "I believe she had a lumpectomy."

Rosamund raised an eyebrow, "The only removal I'm interested in is how those two managed to extract themselves from bed — once they _finally_ fell into one together."

* * *

"I wouldn't have expected you to be literally _running _to return to your office," Beryl said, looking up from her computer to see Elsie bustling down the hall toward them. When she approached the nurse's station, Beryl's face fell at the doctor's expression.

"Are you alright Dr. Hughes?" Daisy asked, reaching out to put a consoling hand on Elsie's forearm, forgetting all sense of propriety in the moment. Everyone had been worried about her. Especially after what had happened with Samantha. It only seemed right to be gentle with her, proffering kindness however they could.

"Has Dr. Carson come in yet?" Elsie said, struggling to catch her breath.

"Yeah, he's waiting for you in his office," Beryl said, turning to wink at Daisy, "He's probably strewing rose petals about as we speak. . ."

By the time she lifted her gaze to Elsie, to make sure she realized she was merely teasing her, all she saw was the back of her head as she took off down the hall, her bag flapping painfully loud against her upper thigh.

She practically threw open the door to her office, and when Charles turned toward her from her desk (where he'd set out her coffee, a small bouquet of fresh flowers) his beaming smile made her even more anxious.

"Good morning," he said, "I hope you don't mind that I pushed in. Your first proper day back; thought I might surprise you."

She exhaled, closing the door behind her quickly. When she turned back to him, he'd taken a few steps closer and could clearly see how distraught she looked.

"Good God, what's happened?" he said, "You look as though you've seen a ghost,"

"Not a ghost," she breathed, The devil, maybe."

He blinked, "Care to elaborate?"

She sighed, letting her face fall into her hands, "I've done something, Charles. I think I've done something very, _very_ stupid."

He furrowed his brow, "I highly doubt that,"

She pushed past him, plunking her bag down in an empty chair and sinking into hers. She took a moment to eye the vase of flowers, pausing only long enough to wonder how he knew she loved hydrangeas — and how he'd managed to find the blue ones.

"Elsie?" he asked, sitting down across from her, "What's happened?"

She flicked her eyes up at him, then let them flutter closed a moment. Her mind was racing. She didn't _have_ to tell him. Maybe she was overreacting anyway. She could just smile. Drop it altogether. Thank him for the flowers.

But something knotted in her stomach, pulled so tight she couldn't breath, and when she spoke, her voice was strained.

"I saw Mr. Green," she said. He tipped his head to one side, his eyes narrowing.

"_Where_?"

"At one of the law offices near my flat. I'd run out the patisserie and. . ." she paused, words escaping her, "He was — there were so many people about. Gawking at him almost, and, so I stopped and I didn't know it was him of course until I looked in and —"

"Elsie, slow down—"

"I went in, after everyone had left— and I spoke to him."

Charles balked, "You — _spoke to him_?" he said, "Wh-whatever did you _say_?"

"I — I _threatened_ him,"

"_What?_"

"I said. . .well, he started in about trying to make it out to be Anna's fault and I couldn't _off_stand the thought of him perpetuating that and I just, I lost my mind for a moment and I went on him. Told him that — if he was planning a suit against Downton, or Anna, _or anyone,_ that if we went down as an organization I'd make sure that _he_ went down with us,"

She looked up at him sheepishly, biting her lip hard. Charles winced, wanting very much to reach over and sooth it.

"My first reaction is to be more than a little impressed," he said quietly, giving her a small smile. He paused, waiting to see if her face would brighten. When it didn't, his darkened in kind.

"I shouldn't have confronted him," she said, "If it comes back to me, to Downton, it won't help our case against him. She scoffed, "It's like I walked _right_ into a spider's web — surely that office had security cameras; grainy black and white footage of a daffy, blowhard of a doctor laying it into a client. . ." she shook her head, "I _really_ fucked up,"

"I gather that a man like Mr. Green couldn't be bothered to take you seriously," Charles said, letting his hands fold together in his lap, "I'm sure he'll just laugh it off."

Elsie looked up, tears hovering in the corners of her eyes, "You didn't see how he was looking at me, Charles," she said, her voice shaking, "It _hurt,_ almost. How he stared. I don't know. Like a _wolf,_ maybe," she shuddered, "I can't help but think — what if he comes after me for it?"

"What, you mean come _here_? He can't be daft enough to set foot in this hospital while there's a suit —"

"No, not here," Elsie said, "That maybe he'd find my flat. That attorney's office is just round the corner from me. I don't like to think of him being so close by."

Charles nodded, "Have you mentioned this to Anna?"

"No," Elsie said quickly, "You're the only person I've mentioned it to — it only just happened. I haven't even had time to look at my patient roster, or have my coffee," she looked down, spotting the bouquet again, "Or, to thank you for the lovely flowers."

He smiled, lifting a hand and waving her off gently, "They're not much but — well, I saw them outside one of the florists on my way to get a paper this morning. They reminded me of you."

Elsie cocked her head slightly, intrigued, "Oh?"

Charles fumbled, clearing his throat nervously, "Yes, well. The blue. You know. Very pretty. Your eyes are. . . _also_ blue and. . ." he was blushing so hard that she thought he might break out into a sweat. It made her giggle slightly. She reached a hand across the desk and took his, squeezing it gently.

"That's very sweet, Charles," she said, "Thank you. They're lovely." she flicked her gaze over to them, reaching up her free hand to gently run her palm across the tops of their round tops, he watched her a moment and it seemed to calm him, "Hydrangeas happen to be my favorite."

He blinked, "Oh, well, perhaps that's why I was drawn to them. I'd only ever seen them in yards, really. They seem to big for a bouquet but the florist did a lovely job arranging them."

"He did," Elsie said. After another moment, she pulled her hand from his, settling back into her chair, patting her jacket for her glasses.

"Elsie," he said, clearing his throat unnecessarily, in order that he might give her time to look up and meet his gaze.

"Yes — _Charles,_" she said, her voice a bit more playful now.

"If you'd — feel safer — you can stay at my flat for a few days. Until it blows over. This. _Thing._ You know, the thing with Mr. Green."

"Oh," she said quietly, "I don't want you to think that's what I was after—"

"No, no," he frowned, "Not at all but — seeing you worried is making _me_ feel worried. And besides, even if he didn't come after you _per se,_ you're liable to run into him again if he'll be frequenting that law office. I'm all the way on the other side of town, really. You'd be free to acquire a scone in peace."

She smiled, her eyes blinking rapidly as she attempted to suppress her tears, "That's very kind of you, but I wouldn't want to put you out any more than I already have. You've been so generous and — taken very good care of me as of late —"

"I don't see it as being put out," he said, "I would like to help if I can. Besides, I think we've established that we mutually enjoy one another's company," he made to stand, nudging her coffee cup toward her, "Anyway, I've got to get off to my day — have your coffee, take a moment for yourself, and think on it. Let me know what you've decided by the end of the day."

She looked up at him, her face aching as she did. The pain of an internal smile that couldn't seem to break through acute tears, "Thank you."

He waggled his eyebrows at her, "You say that now but — if you do decide to take me up on the offer, you might be very dismayed at the person I really am. In the comfort of my own home."

"You've a secret life I'm not privy to?"

He laughed, stuffing his hands into his pockets, "Quite the opposite — I think you'll be disappointed by what an old fuddy-duddy I am."

* * *

"Mum, _come on_ — you've got to eat something. You've got to keep your strength up," Sybil implored, reaching over to stroke Cora's hair. It was unwashed, plastered against the satin pillow she'd not lifted her head from since she was released from the hospital. Robert had promised to take a few more days off, but an early-morning phone call from Violet saying that they had been served papers made him leap from the bed — escaping from one horrible nightmare to another.

Sybil was content to tend to her mum. She'd always been the one to notice when Cora was coming down with a flu, or her back was aching. Mary and Edith _never_ noticed or, if they did, never thought to _do_ something about. Even when Sybil had been a little girl, she'd been the first to run and cuddle her mother if she was down with a cold. The first to bring her honey tea and rub her feet. Cora would, of course, return the favor ten-fold, staying up all night when the girls were feverish. Cool cloths on their foreheads and storybooks. Holding their hair out of their clammy faces if they had to be sick. Even when Sybil was a bit older, if she'd have a rather bad period and ask to be let off school for the day, Cora would never say no. She would bring her a hot water bottle and the raspberry leaf tea that she promised would make it better. If Sybil felt poorly and wanted to sleep, she'd hear her mum quietly leave the room, and when she woke a few hours later, there would be a stack of magazines next to her bed and a Cadbury chocolate on her night table.

This was different, of course. Not something that a long bath or a chocolate sweetie could fix. Sybil wasn't so naive as to think that it _could_ be fixed, but even though she was grown up, seeing her mother out of sorts was unnerving. She would have dug out her old tutu and spun around until she saw stars if she thought it would make her laugh, bring her happiness even for a breath.

"Mum? Won't you even have a cuppa? It's gone cold now— but I'll go make a new pot."

"Just leave me _alone_," Cora said, her voice muffled by the pillows. Still, the atmosphere in the room thickened and all at once Sybil felt a strange, unwelcomed feeling. She couldn't remember ever feeling such a tangible sense of rejection from her mother before. Perhaps she never had. And it struck her like a fast blow, an emotional whiplash.

"Mum?" Sybil said, curling up against Cora's back, "Mummy?"

All at once, giving her almost physical whiplash as well, Cora whirled around, kicking the blankets back, staring at Sybil with wild, tired eyes, "Sybil get _out, _just leave me alone. Go find something to do."

"But mum I'm just—"

"Stop _mothering_ me, Sybil! You're not a doctor or a nurse — _whatever _— yet, so keep your medical opinions to yourself. I get enough of that from your fucking _father_."

Sybil blinked, her eyes hot with tears. Cora had never spoken like this to her before. Probably not to anyone, at least not in her daughter lifetime.

"Alright," Sybil whispered, slipping off the edge of the bed, "I'll be downstairs,"

Cora rolled over, waiting until she heard Sybil quietly pad out into the hall, shutting the bedroom door quietly behind her. Then, when she heard her start to go downstairs, she pressed her face into the pillow — and screamed.

* * *

"Where's Dr. Swire?"

Matthew turned and looked up from where he was scrubbing away at his hands. Mary stood in the doorway, arms folded neatly across her chest, chin lifted.

"She's still sick," Matthew said, "I'm kind of surprised to see you, actually. I would have thought, with everything that's happened, that you'd have given in to taking some personal time."

Mary shrugged, "I go where I'm needed. And for now," she took a step into the room, turning on the faucet next to him, "I'm needed _here_."

She set about scrubbing in, feeling Matthew watching her wordlessly. When she finally did look up, he was staring at her.

"What?" Mary frowned.

"Oh, nothing, I just —" he shrugged, "I'm trying to figure out if you're totally suppressing a well of emotions about the current climate of crisis in your life — or if you are _truly_ unbothered by all of the chaos."

Mary looked up, giving him a slight smirk, "What would it matter to _you_?"

"Well, from a practical standpoint, it will impact how I approach this surgery. I mean, if you're going to balk halfway through, faint or something from your sadness, then I'll be treading lightly. If, however, you're truly fine, then I suppose I'll just carry on."

Mary pursed her lips, then sighed, lifting her hands from under the stream of water, "Well, I'm fine for the moment. Is that good enough?"

Matthew shrugged, "I suppose it will have to be."

Mary gave him a terse grin and pushed into the OR, but waited for him to catch up, holding the door open for him with her foot.

An olive branch.

* * *

"Richard?"

Dr. Clarkson blinked away from his computer screen toward the door, hoping he didn't look as haggard as he felt. Isobel hovered in the doorway, her fingers curling around the molding.

"Your first patient is in exam room one."

He nodded, "Thank you," but he didn't make to stand. He just sat at his desk, smoothing his fingers over the keyboard of his computer.

"I've taken their vitals and recorded them. . ." Isobel pressed, "They're ready for you."

"Yes, I'll only be a moment longer," he said, waving her off.

Isobel sighed and opened her mouth to speak, but decided against it. Everyone was on edge, really, it wasn't as though she was surprised. She only wished that there was something she could do, or say. And part of her struggled to understand what of the myriad problems they'd faced as of late had him in such a hopeless place.

She turned, heading down the hall, sticking her head into the exam room to tell the patient Dr. Clarkson would see him shortly, then she carried on to the front desk. She was surprised to see Sybil sitting in her office chair, swiveling dejectedly.

"Sybil!" she said, "My, you're up early."

Sybil looked up, her face gaunt, "I hope you don't mind that I dropped by,"

"Not at all," Isobel said, leaning on the edge of the desk, "I'm just surprised."

"Well, mum was—" she lowered her gaze, contemplating her words carefully, "—_aggravated _by me this morning. So I thought maybe, if you were up for it, I could shadow you for a while today?"

"Cora didn't want you to stay at home with her?"

Sybil nodded, "She actually. . ._yelled_ at me. It was really odd. She's never been that mean to me in my _life._ And I want to think she's just sad about the baby and maybe mad at Dad about this whole lawsuit thing but —" she shrugged, "I was only trying to help. Just wanted her to have some tea and maybe some toast—"

"Oh, _Sybil_," Isobel said, "Darling. I'm sorry you had to bear the brunt of Cora's grief. . .but she loves you, you know that?"

"Yes," Sybil whispered, "I just feel bad."

"Of course you do," Isobel said, leaning down and pulling Sybil into a hug, "Would restocking some shelves make you feel better? I've got a new shipment of insulin that could be put away, if you're so inclined,"

Sybil gave her a small smile, "I'll do whatever. I just need a little space."

"And space you shall have," Isobel said, patting Sybil's shoulder gently.

"Isobel?"

She looked up. Dr. Clarkson had appeared in the hallway. His hands were shaking.

"What is it?" she said, taking a tentative step toward him.

"I . . .I need you to reschedule Mr. Abbott for another day. I think I need to go home. I'm feeling very unwell."

"Richard?" she hushed, reaching out to put her hand on his forearm, "What's wrong?"

He laughed nervously, his eyes flitting about. If he noticed Sybil Crawley a few feet away, he didn't show it, "This is going to sound very odd but. . .I think I may be having some kind of. . .attack?"

"What?"

He shook his head, licking his lips repetitively, "Not a heart attack or anything just — a panic in my chest. Almost as though. . .as though I can't breathe—"

"Okay," she said quietly, "Let's go back to your office," she turned to Sybil, "Darling, go to exam room one and tell Mr. Abbott that Dr. Clarkson has an emergency and he's very sorry, but he'll need to reschedule. Give him an appointment card and —"

"I can reschedule it," she said, "I know my way around an office calendar, at least."

"Alright," Isobel nodded, "Very good. When you're done, man the phones."

"Okay," Sybil said, "Is everything okay?"

Isobel gave her a terse, uncertain smile, "It will be, darling. It will be."

* * *

"I'm not sure I understand. . ." Robert said, hovering in the far flung corner of the hospital medical library, the only place it seemed they could talk without being watched.

"What is there to understand?" Violet huffed, "We're about to be embroiled in a high profile lawsuit with a pharmaceutical company. It's like GlaxoSmithKline all over again. You know the press lives for these_ fuck-ups_."

Robert looked at her a moment, wondering if he ought to tell her check her language — but he thought better of it. Now was not the time for cheek.

"Sybil and Tom will need to testify, then." Robert said, shifting uneasily.

"Absolutely," Violet said, "For her own good, I suggest we pull Sybil out of school until the nightmare is over. Certainly if she remains on a university campus she'll be mauled by reporters, and she'll _no doubt_ fail her coursework. We'd be better off to let her have an extended leave of absence with her resume intact than allow her to go back and muck it all up."

Robert sighed, running a hand through his hair, "I'll speak to Cora about it,"

"Why bother?" Violet said, "Don't try to talk to her about anything for at least six months. She's drowning in grief, whether or not you see the waves."

"I _do_ see it," he said firmly, "And _I feel_ it — more so than you _ever_ will, so don't try to tell me—"

"Robert, I'm sorry," Violet said, her voice low, "I just — I feel far too old to be worrying about all this," she sighed, pinching her nose between her thumb and forefinger, "Downton's not what it used to be. Maybe if it crumbles, we can rise from the ashes—"

"_Stop,_" Robert said gently, "Don't give up on it just yet. It's stood the test of time. We all have. You make it sound as though the world has turned entirely on its head and—"

Violet stiffened, looking over his shoulder out the windows of the library into the hallway. Her mouth dropped open just slightly and she hustled by him, throwing the door open and peering down the hall.

"What's wrong?" Robert said, "You look like you're going mad."

"Maybe I am," Violet said, "I could have _sworn_ I just saw a crowned princess gliding down the main corridor. . ."


	35. Euphoric

**A/N: **Hello darling readers! And you are darling, so dear to me you couldn't possibly know how much! I've decided that since my life has busied up so much that I can't seem to write as regularly, I would publish shorter chapters instead of waiting until they are longer. You'll see them more frequently, they just won't be so long. You've all been so lovely about reading and following this journey that I can't stand the thought of letting you down! Anyway, this chapter has a few trigger warnings you may wish to heed, including **discussion of suicide, suicide attempts, depression, panic attacks, anxiety and a car accident. **

Also a shout to _theladychelsieofdownton_ and_ ladyaureliacrawley_, a nod to each of you herein!

* * *

"Good morning, April. So glad to see you're awake," Edith said, looking down at the girl in the bed before her who — if she wasn't misinterpreting — appeared to be consumed with rage despite being nearly ashen from exhaustion. Edith swallowed, gesturing behind her, "This is Dr. Painswick. She's the Chief of Psychiatry here at Downton. We'd like to talk to you a bit and explain what will happen next. Now that you're awake,"

April narrowed her eyes first at Edith, then slowly raised her gaze to Rosamund.

She didn't speak.

"Hello April," Rosamund said, sitting down on one of the wheeled chairs, walking herself over to the edge of the hospital bed, "You may already know my first question. Do you know why you're here?"

April blinked. Then, slowly, as though it pained her to do so, she nodded.

"Why did you take those pills?" Rosamund asked simply, folding her hands in her lap.

_Waiting._

April turned her head away, toward the window, letting her eyes flutter closed. Edith took a step forward, settling a hand onto Rosamund's shoulder.

"May I?"

Rosamund shrugged, "If she's not ready it's best not to force her,"

"Well, I have a _different_ question to ask," she said, lowering herself onto the foot of the bed, flipping April's chart open, "I noticed that you've been in the emergency room several times over the last few months, April," she began slowly, deliberately, "You were having a bit of trouble. . ."

April didn't move.

"What are you talking about Edith?" Rosamund said, craning her neck to look into the chart. Edith showed her, pointing to an entry. Rosamund shook her head, leaning in to whisper to her, settling one hand on the edge of the bed to steady herself properly, "Oh,_ that_? No, no, Edith. Didn't you see the discharge note? Her scans were clean, blood was clean — the admitting physician said it was stress induced and I'm apt to take his word for it."

Edith frowned, "Well, _I'm not_," she said, turning back to April, "I'd like to hear _her_ side of the story, if you don't mind," she gently settled her hand against April's leg atop the blankets, then immediately lifting it. _Don't touch patients. Particularly not patients you're admitting to psych, with unclear histories. Possibly violent at the drop of a hat, _her university teachings echoed in her head. She blushed, silently chastised herself, then cleared her throat and spoke again. "Perhaps you'd tell me what happened?"

April did look over at her then, eyeing her suspiciously. She struggled to clear her throat a few times before rasping out a nearly inaudible response.

"I'm _not_ crazy," she breathed, "And I don't know how to prove it."

* * *

"Richard, here, drink this — _please_." Isobel said, handing him a bottle of water. She'd taken him outside, on the periphery of the hospital grounds, to a bench that she enjoyed sitting on to have her lunch each day. It was a quiet spot in a heavily wooded area, a bench that seemed well-loved, engraved with the names of a few benefactors. It sorely needed paint, but Isobel was hesitant to mention it to any of the facilities people. She rather liked the rustic look; gave it some character. It was nice to see something that didn't shimmer and glisten with sterility.

"Th-thank you," Richard said, inhaling a shaking breath, "I-I'm so s-sorry to trouble you with this," he said, "I don't kn-know what's ha-happening,"

"I'd venture a guess," Isobel said, "But I don't want you to think I'm _diagnosing_ you."

He managed a small smile at this, "I'm all ears, Isobel. Give me the ba-bad news."

She sighed, "I think you're having a panic attack — you've certainly been anxious lately, more so than I've ever seen you in your life," she lowered her gaze, looking absently at the dirt beneath their feet. She could see that his knee was shaking almost violently. Without a second thought, she reached over and placed her gentle hand on it.

"Ye-yes, well," Richard said, taking a small sip of water, "What's caused it?"

"My guess is that is has something to do with Cora Crawley's termination procedure," she said softly, "You really haven't been yourself since."

He closed his eyes a moment, nervous perspiration dripping down the side of his face, "I think perhaps you're right, Isobel. That day," he sighed, slowly, trying to steady himself, "It hasn't set well with me at all."

Isobel frowned, "Do you feel as though you should have done something differently?"

He shrugged, "I don't know," he said, "_I honestly don't know_," he turned, looking up at her pleadingly, "I keep replaying that conversation over and over again — did I make the right recommendation? Would it have been better for Cora to hold the child? To let her finish the pregnancy— if only to have seen the baby? Would it have been worth the risk to her? For them all?" he shook his head— entirely lost.

"You made the best recommendation you could given the circumstances. You took the mother's health into account and gave it proper precedence," Isobel said firmly, "You didn't allow your relationship to the Crawley's influence your clinical judgment."

He looked straight at her, then, his eyes clouded with tears.

"Yes," he said quietly, "But _should_ I have?"

* * *

Beryl blustered around the corner of the ward and huffed her way to the nurses' station. As per usual, they were out of sterile dressing and materials was slow on the uptake restocking, she didn't have a _single_ open bed on the unit and while Dr. Hughes had returned, it didn't exactly seem like she was in fighting form.

And, to make matters worse, no sooner had she rounded the corner down the hallway than she nearly ran smack into a. . .

"What the _fuck_ is this?" she breathed, shaking her head. As if on cue, Daisy popped up, smiling widely.

"I can't believe it!" she said, "Beryl, this is my friend from Uni!"

Beryl huffed, "You didn't tell me you went to uni with a bloody member of the royal family," she said, eyeing the girl in front of her. She was head to toe clad in classic fairytale princess garb, her long blonde hair falling perfectly over her shoulders and her bright, beaming face making Beryl vaguely uneasy — if not also subtly amused.

"I'm Ally," the girl said quietly, "But don't tell anyone, yeah? If anyone asks, I'm Princess Aurelia."

"Whatever floats your boat, love," Beryl laughed, "But why are you here?"

"She's come to visit the children," Daisy said, "Right Ally?"

The girl nodded sweetly, "It's a bit of a side job, you see. Who wouldn't want an excuse to get all dolled up and spend the day with some great kids?"

"And does Dr. Hughes know about this?" Beryl said, looking over Ally's shoulder to Daisy.

"She hired me to come in part-time," Ally blinked, "I'm sorry, I assumed she would have told her staff as much," she looked around nervously, "I was supposed to meet her here before I begin but. . .I haven't been able to track her down. Of course, I'm sure she's _very_ busy, and I don't mind waiting," she turned back to look at Daisy, "It was a real treat to get to see Daisy anyhow and we've had a lovely time catching up."

Beryl sighed, "Well, unless you can wave that magic wand of yours and make some dressing appear in that store cabinet, I need Daisy to call up to facilities and give 'em a stern talking to."

Daisy cringed, "Oh, please, do I_ have_ to? I hate calling up there. I'm not good at it at all."

"Well you'd better learn to be good at it because if you want to be a nurse, that's half the bloody job."

"I'll do it!" Ally said brightly, and before either Beryl or Daisy could protest, she'd reached over and grabbed the phone, dialing the switchboard.

"Yes, hello. Good morning," she said sweetly, "Would you be so kind as to connect me to facilities, please? Thank you ever so much." she waited a moment, playfully wagging her wand at Daisy and giving her a small wink, "Yes, hello. This is Ally in Pediatrics. How are you this morning? Oh, lovely to hear it. Yes. I'm well. That is, except for the fact that we've got no more sterile dressings in our store cabinet. We were hoping that you could run some down to us? Oh yes, thank you. That would be grand. I do appreciate it, I know you're busy. Yes, that's true, we are too! Okay. See you soon. Ta."

She gave Beryl a grin and waved her wand, "Your wish is my command."

* * *

"I'm sure you've got a _million_ things to do," Anna said quietly, staring into her coffee cup. Elsie sighed, crossing her legs as they sat on a bench outside of the hospital's main entrance.

"I'll _always_ have a million things to do, Anna," she said, "It's just a matter of getting my priorities straight."

Anna sighed, "Well, I'm glad that you told me that Mr Green is about. I wouldn't have wanted to run into him," she flicked her eyes up, "Can you imagine if you'd actually run into him? Had words with him? _Good God_," she said, sipping her coffee.

Elsie winced at the lie she'd told. She did truly hope she was protecting Anna by omitting the detail of her confrontation. Surely it would come out later — but why worry her?

"How are you feeling?" Anna asked gently, "I know you had the best post-operative care Downton has to offer. . ." she gave her an impish grin, "But you must be sore and tired. . ."

Elsie shrugged, "I'm well enough," she said noncommittally, "But you're alright for the moment, yes? I've been worried about you."

"I'll be alright, Dr. Hughes. Whatever happens, I know who I am. Who I can trust."

Elsie smiled, "Good that you do, but it will change. Life is fluid in that—and many other—regards."

"I suppose I should say — this whole experience has really opened my eyes to who people _really_ are. You can know people, or think that you do, and then something happens — a tragedy of some description — and you get a glimpse of who they really are," she shrugged, staring into her coffee cup again, "The revelations haven't been all bad, though. Some people really shine in a crisis."

Elsie smiled to herself, "That's true," she said, reaching over to gently pat Anna's hand.

"I'm glad that you've. . .struck up a proper _friendship_ with Dr. Carson," Anna said, blushing slightly, "I didn't mean to imply that there ought to be more than that but — well, if there is, that's fantastic, _really_, but, of course it's not my business I just — you're both lovely people and you've worked so hard for such a long time. You deserve to have someone in your life who understands you. _Really_ understands you."

"You're a tender hearted girl, Anna Smith," Elsie said, "And a very perceptive one, too."

"I'm grateful to know that I have you both on my side," Anna said quietly, "I wouldn't have known who to turn to. There really isn't anyone else and. . .well, anyway. I should probably get back."

"We both should," Elsie said as she stood, "But I'm glad we had a moment to talk about all this, Anna. The road ahead is apt to be a long one no matter what comes of it, but you won't go it alone."

"Thank you, Dr. Hughes," Anna said, tucking an errant strand of hair behind her ear, "You don't know how much it means to me to have someone on my side, no matter what."

Elsie sighed, looking toward the hospital entrance where Charles was hovering, donned in scrubs and helping a nurse ease one of his surgical patients out of her wheelchair and into a waiting car.

"Oh, I think perhaps I do."

* * *

"Sybil, darling, you're a peach," Isobel said, leaning down to kiss the girl's cheek as she threw her purse beneath her desk and flopped into a waiting wheeled chair.

"Everything okay?" Sybil asked, moving to take the phone headset off, shaking out her long tresses lest they get tangled.

"_Tickety boo_," Isobel sighed, "Really, thank you for your help. Dr Clarkson thanks you as well," she sighed, reaching for a long gone cold cup of tea, "You should go home and check on your mother. She's probably wondering where you've gotten off to."

"I doubt that," Sybil said, "She's probably still asleep."

"Well, all the better," Isobel said, "If you hop along now you'll get home before she wakes and she won't even know you were gone."

"That's what I'm afraid of," Sybil said meekly, and when Isobel looked up, she saw that the girl had begun to cry, "Oh, Sybil, darling," she said, scooting her chair closer so that she could embrace her, "Come now, it'll be alright. She'll be alright."

"I know, I know, I just — I'm not used to her being so _hateful_," Sybil said, "I can't help but think she might never be the same again. That it's changed her."

Isobel rested her chin atop Sybil's head, stroking her back gently, "I've known your mother for many, many years, Sybil. She's made of sterner stuff than that. Certainly things will change, because we all do. Whether we want to or not, mind you," she gently lifted Sybil's chin with her finger, "But one thing that will never change, come hell or highwater, is how much she loves _you._"

"I know," Sybil said, "I'm not worried that she hates me —" she swallowed hard, tears streaming down her face, "I'm worried about how much she hates _herself_."

* * *

Alex Green was exceptionally pleased with himself as he strode out of his attorney's office, stepping out onto the quiet streets of Chiswick. Other than that _bitch_ of a doctor from the hospital daring to accost him in the waiting room, the appointment had gone swimmingly. There was plenty of blood in the water at Downton, probably more than most of its employees were privy to, and he now had an absolute shark of a solicitor on his side.

It was perhaps because he was so distracted, marveling at his own success, that he did not see the car coming toward him as he stepped into the street.

Onlookers would find it curious that at the moment he was struck, he had _quite_ the beaming smile on his sorry face.


	36. Prognosis

_"Patient is a 36 year old male, struck by a passenger car head on. Cervical spine immobilization and cricothyrotomy at the scene; couldn't intubate because of the maxillofacial injuries. Bagged him with lactated Ringers, BP's still falling. Airway my also be obstructed by tracheal deviation — witnesses said he went down hard. He's non-responsive to pain," Tom said, running alongside the gurney as he and the emergency room techs careened through the hallways into the nearest open trauma bay. Dr. Spratt, who was midway through his double shift, staggered as he attempted to keep up. _

_"Got an ID on this bloke?" he said, "Those facial injuries aren't gonna give us much," _

_Tom shook his head, "He didn't have a wallet on him and no one at the scene recognized him. One person thought maybe he'd come out of one of the shops, a bakery or something —" _

_"Who hit him?" _

_"Hit and run, I'm sure they've put an APB out on the car by now but—" _

_"Well, they'd better figure out who this bloke is," Spratt said, snapping on his rubber gloves, sighing as he watched the man's blood drip from the gurney onto the tile floor beneath his feet, "So we know what to write on the death certificate." _

* * *

**Several months later, Christmas Eve Day. **

"What a sorry lot we are," Beryl said, brushing the crumbs from her scrubs as she reached for another of the frosted biscuits she'd brought for the nurses' station. She looked about at the gaggle of her friends and coworkers who sat slumped in their swivel chairs: Anna, whose shift had ended an hour ago but didn't particularly have anywhere else to be, Daisy with her festive earrings; tiny Christmas tree bulbs (one of which had burned out, the other blinked slowly next to her cheek), Phyllis and Molesley who hovered against the wall peaking down the hallway every now and then, listening for call buttons. And next to Beryl, nibbling quietly on her own biscuit, was Dr Hughes.

"The only one who'll be sorry is Dr Carson," she sputtered, popping the last of the biscuit into her mouth, "There won't be any of these left by the time he's out of surgery."

Everyone turned slightly, eyeing the clock: it was just after three in the afternoon and they were all in a bit of a slump. The sugar binge was not likely to help.

"We'll save him one," Daisy said, reaching for the tin — shaking it, she frowned. _All crumbs._

"Well, we'll all have our fill of sweets at the party." Beryl said, turning to Elsie, "You two aren't skipping out on us, are you?"

"No, we'll be there." Elsie sighed, "Where else would we be?"

"Here?" Beryl laughed, "Avoiding the yuletide?"

Elsie shrugged, "He's actually the one keen on going," she said, "I would have thought I'd've had to twist his arm, but he seems quite determined."

"He's probably chuffed to have a pretty lady on his arm," Daisy piped up sweetly, bouncing in her seat a bit.

Elsie blushed, letting her eyes fall to her lap. Beryl gave her a swift pat on the thigh, "Oh, don't get your panties in a twist, the whole hospital knows you two are shackin' up. No one thinks less of you for it."

"If anything I think it just confirms what we've all assumed. . ." Phyllis said quietly, looking up at Elsie with an impish grin.

"Well now, don't be so quick to think you know us." Elsie huffed, "We're good friends—_companions_ I'd even say — but I hardly think there's any more to our story. That ship sailed a long, long time ago."

"Never say never," Anna said gently, "He's never looked as happy as he does when he's looking at you."

An inspired _aww _rang through the nurses' station and Elsie's flush deepened, and she covered her face to hide it, "Stop teasing me!" she said, "Haven't you all got something better to do?"

"Not_ really_," Molesley said, "Luckily not many are here for the holiday." He rose from where he was seated and looked at the admit board, scanning it a moment before he sat down again, "I guess it's a good thing, right? No kiddos should be stuck here when they should be home waiting for Saint Nick."

As if on cue, a call button rang out and Phyllis leapt up before anyone else had the chance.

"Anna, you were off an hour ago," Elsie said gently, resting her hand on Anna's upper thigh, leaning forward slightly so that she could lower her voice, "Don't you and Dr. Bates have plans for tomorrow?"

Anna shrugged, "We're not really Christmas people," she said, wrinkling her nose a bit, "It's kind of a family holiday."

Elsie sighed knowingly, "Well, that's true I suppose. But there's more than one kind of family," she eyed Anna a moment, "The one you have — and the one you _make_."

At this, Anna managed a small smile, "What about you, Dr. Hughes? You and Dr Carson have plans?"

Elsie laughed, "Other than sleeping late — no, not a thing planned. If you're bored tomorrow afternoon come over for tea. No point in us drinking all the eggnog alone."

"There he is now, the sorry sod," Beryl laughed, pointing down the hall to where Dr. Carson was huffing and puffing, his surgical mask clenched in one hand. He hadn't even changed out of his scrubs and wore an expression of fragile frustration.

"Oh no. . ." Elsie said, standing and taking a few steps toward him.

He almost didn't see her, lost in some internal reverie. He sputtered, grasping her by the forearms and gently moving her aside, "Nothing, nothing. We'll talk later."

"Will we see you at the Crawley's tonight, Dr. Carson?" Daisy said, trying not to appear to eager.

He frowned in Elsie's general direction and they communicated silently for a moment until he understood, "Oh — erm. Yes. I think."

"Was that your last case today?" Elsie said, appearing at his side.

"Yes," he said pointedly, then turned to the rest of his colleagues, "You didn't save me a biscuit?" he said, forcing a smile, though his voice couldn't have been more devoid of mirth. Everyone looked at him perplexedly until he took off down the hallway toward the men's lockers.

Elsie shrugged, a bit frazzled, grabbing her purse and coat before scuttling after him.

* * *

"You've done a lovely job darling," Robert said, leaning against his wife's side as they looked at their friends and colleagues, enjoying themselves amidst the garland and dimly lit lights strung up round their home.

She smiled up at him over the rim of her champagne flute.

"I know it's been a dreadful few months and this was probably the last thing you wanted but —"

"Oh Robert, it's fine. Really. It was nice to have something to focus on. Something happy."

"Have I made you happy, Cora?" Robert whispered, tucking a fallen strand of hair behind her ear, "Have you been happy?"

Without so much as a glance over her shoulder, Cora leaned up and kissed him soundly on the lips, the answering sparkling in her gaze.

"Get a room!"

They both turned at the sound of Sybil's chippy voice. She'd had a few drinks — and they'd allow it. After the mess of a year _she'd _had they were just pleased to see her smiling.

"Sybbie_ love_," Robert said, pulling her into an embrace so she was festively sandwiched between both of her parents, "Thank you so much for helping your mum put this all together. I must say, it's the most lavish Christmas Party we've held in decades. Wherever did you find all this glitter?"

Sybil laughed, her lips hovering over her glass, "_I've my ways_."

"No doubt," Cora smiled, kissing the side of her daughter's head, "No go on — where's that friend of yours, Tom? Surely he's about. . ."

"He _was_," she pouted, "But he had to go out on a call. I hope he'll come back, though."

"Well, in the meantime, perhaps you'd let your old dad challenge you to a rousing game of — what's that thing Granny and Isobel are playing?"

"Oh Lord!" Sybil cackled, "_Cards Against Humanity_? No Dad, we're _not_ playing with them. Absolutely not."

"Come on, it can't be that bad —" he said, playfully dragging her across the room.

"Mum, _save me!_" Sybil laughed, eggnog spilling down her hand.

"Darling it was only a matter of time before someone would have to explain _Harry Potter erotica_ to him. . ."

From across the room Sybil squealed and Cora couldn't help but grin: whatever the reason for the joy, she'd take it just now.

* * *

Edith looked about for a place to leave her glass as she fumbled for her cellphone. It could only be work — _it only ever was work_, even on Christmas Eve. She managed to answer it, tucking it between her ear and shoulder, as she slipped away into the kitchen, settling her wine glass onto the counter to be forgotten.

"Dr Crawley, I'm so sorry to call you on Christmas Eve but . . .this is Dr Gregson at Saint Mary's."

Edith bit back a smile, "Dr Gregson — no no, it's wonderful to hear from you. I've been hoping you'd call or at least send me a progress note."

She could almost hear him grinning on the other end of the line, "I think you'll be pleased to hear that the patient you referred, April, the mystery as it were, has made significant progress indeed. It didn't seem right to send a note when we've had such a glorious turn of events. She's taken steps today, you see. Nearly made the entire length of her room. We still haven't got a proper inkling as to the reason for her paralysis, but she seems to be overcoming it. I was hoping that. . .after the holiday, perhaps, you'd come to London. She'd love to see you."

"Well, I'd love to see _her,_" Edith said, "And hear about the work you've done with her, and on the case. I'm chuffed that my instinct was correct. . ."

"While you're here perhaps — perhaps I could take you to dinner?"

"I would like that very much," Edith said, biting her lip slightly, "Happy Christmas, Michael."

"Happy Christmas, Edith."

* * *

"Our dear Dr Carson hasn't had a _single_ drink," Beryl said, downing her second, "He's not on call is he?"

Elsie sighed, swishing the remainder of the cider at the bottom of her glass, "No — I don't know what's gotten into him. He's been a bit. . ._edgy_ lately. I don't recall Christmas having any negative connotation for him — do you think I've missed something?"

Beryl shrugged, "No, if he had a problem with it we'd all know about it by now. He can be a bit of a Scrooge but he's not The Grinch."

"That's apt_,_" Elsie laughed, tipping her glass to her lips. When she lowered it she saw him striding toward them, his brow knitted.

"I'm going to go . . . do something with myself so you two can have a moment," Beryl said, staggering up from the couch, "I'm not even going to make an excuse, I'm too plonked."

"As always your directness is appreciated," Elsie said, handing her glass to Beryl and shifting uneasily in her seat as Charles came toward her.

"Um. . .might we—later, not now—have a moment alone? We can sneak away, perhaps. At some point this evening." Charles stammered, his face softening.

"Well. . _.sure,_" Elsie blinked, "Just say when."

Clearing his throat and stuffing his hands into his pockets, he looked over his shoulder at where everyone had begun to whoop and tipsily dance about. Even Mary seemed to be relaxed enough to nod her head pleasantly to the music as Matthew handed her another drink.

"You can sit down," Elsie said, gesturing to the vacant side of the couch, "Unless you'd like to dance?"

He shot her a look, and she merely raised her eyebrows in response._ A challenge._

"I don't really understand all this Christmas music being sung by pop stars. Whatever happened to Bing Crosby? Nat King Cole?_ Sinatra_!"

Elsie nodded toward where Roz Painswick hovered at the speakers, clicking through her iPhone. "If you ask I bet she'd be happy to indulge you. . ."

Charles sighed, "It hardly matters. . .I just. . .perhaps I enjoy_ tradition_. Especially around the holidays. Probably makes me something of a spoil-sport."

"You can't account for taste. These kids don't remember the classics. . .their _parents_ hardly do. But who can resist White Christmas as sung by Dear Martin? Riddle me_ that._"

He smiled, looking over his shoulder again.

"What happened earlier?" she said, recrossing her legs, "You never said."

"Oh — it was nothing I just—" he stuttered, reaching up to loosen his tie, "Do you want another drink?"

"Um — I suppose — why don't you have one. You're wound a little tight."

He looked at her, slightly wounded. "Cider for you?"

She nodded slowly, watching him take off across the room, "And a dram of whiskey wouldn't hurt."

* * *

"Isobel, I'm about five drinks away from enjoying this," Violet winced, covering her eyes as she watched another group hurry to stand around the piano for more caroling. One of the CNA's, a handsome young man, had proven quite the pianist and had been entertaining all evening.

_"Boo hoo for you!"_ Isobel laughed, sputtering into her drink, "I'm truly enjoying this folly. _Oh!_ Look, Richard's joining in. He's actually got a _very_ nice voice —"

"And _you_ would know—" Violet tutted.

"Don't be vulgar."

"This from the woman who thought it was funny to play the "assless chaps" card in response to the query, "_What will always get you laid_?"

"It's fucking_ funny!" _she hissed, "The whole _point of the game_ is to be vulgar."

"Vulgarity is no substitute for _wit," _Violet said, turning her attention to the music which had all but drowned out their conversation, "And let it be known that pinot noir is no substitute for _pitch._"

Isboel threw her a look and they both dissolved into giggles as a rather loose rendition of Silver Bells rang out through the room.

* * *

"You look beautiful," John said, wrapping an arm around Anna's waist. She looked up at him, then up above their heads at the mistletoe hanging in the doorway.

"I swear I didn't plan this," she said, letting her gaze drift up. John followed it, then smiled, placing his finger beneath her chin so that he could tip her head up to receive his kiss.

"I wouldn't have minded if you had," he said, turning back to the raucous group at the piano, "It's like seeing a dog walk on its hind legs. . ." he laughed, nodding in particular to the more established and respected staff, like Richard Clarkson, who made earnest attempts at tap dancing as everyone giddily clapped along.

"Dr Hughes said we could come by tomorrow. . ." Anna said, leaning against his shoulder, "I think I might like that."

John looped his arm through hers, letting his hand come to rest atop hers, "That would be nice," he said, turning to look down at her, "Did I ever tell you the story of how Dr Hughes singlehandedly saved me from having a botched meniscus repair?"

Anna brightened, "What? No, you most certainly did not. . ."

"Well, it's quite a tale. . .when I first came to Downton I had quite a pronounced limp, you see. . ."

* * *

"I think . . .I want to say a thing. . ." Robert slurred, grasping Cora's forearm.

"Oh, darling, no. . ." she said, pushing him upright, "You've had a few—"

"I've had _so many few. . ._" Robert grinned, a small giggle escaping him, "I am delighted. Filled with good cheer."

"I wouldn't call it _cheer _exactly. . ." Edith said, appearing at her mother's side, "Should I brew a pot of coffee?"

Cora sighed, "You could transfuse him with it and it wouldn't help. Just. . .help me keep an eye on him."

"_My God!_ There are people in my house I've never seen before! Who is that tiny girl over there? Does she work at the hospital or is she a patient?"

"That's Daisy Robinson. She's a nurse on pedes."

"Marvelous! She's so _short_." Robert said, "How do short people get by in this world? How do they reach things?"

Edith stifled a laugh, "Dad, maybe — you'd like to sit over here with me."

"No, no, I must thank everyone—"

"You really mustn't," Cora whispered, pushing him toward Edith. Just then she saw Mary come round the corner, wine glass perched in her hand.

"Mary! Mary, quick — sing something, please? We've got to distract your father. He's about to make an ass of himself."

Mary raised an eyebrow, "When have I ever prevented that in the past?"

Cora glared, "Please, just —help?"

"Oh _fine_," Mary sighed, handing her mother her wine glass and gliding over to the piano.

"Look, darling, Mary's going to sing for us!" Cora said, kneeling before Robert, who had finally agreed to sit down, as though he was a small child.

"Silent Night. C Major." Mary said, leaning against the piano and flashing a toothy grin.

* * *

Everyone gathered around and listened — it was true, Mary Crawley did have a lovely voice, and between that and the crackling fire, the light snow outside and the festivities afforded to all by plenty of alcohol, a nice settled feeling fell over the evening like a cozy blanket.

"Maybe this is a good time?"

Elsie looked up at Charles, who had appeared beside her. She raised her eyebrow slightly — of all times they could sneak off she'd never have expected him to leave when Mary Crawley was the center of attention. But she didn't question it. Instead, she grabbed them both a glass of cider and followed him into the hallway.

They disappeared into the Crawley's library, a warm, quiet space just far enough from the party that the gentle chords of Silent Night followed them— _but only just._ He closed the door behind them and began to flex his hands nervously. She offered him a drink, but he declined it.

"You're making me _nervous_," she said quietly, searching his gaze for whatever it was she'd been missing all night — for the last few weeks, really. Whatever it was that had been eating away at him, was now clearly arriving at a head.

"I don't mean to I just — I've been thinking about our . . _.arrangement_."

She blinked a few times, her hands beginning to shake from holding the two glasses of cider, which now felt as though they each weighed a ton.

"Oh?" she said, more of a sound than a proper exclamation. "I see. You're. . .rethinking it?"

He huffed, "No, _no no, _not at all. Quite the contrary. I think. . .perhaps we should. . ."

She waited, her lips parted slightly, "I . . .I don't need my name on the_ lease_, Charles, if that's what you're getting at. If we. . .if we stop doing this, if you want to move away, work at another hospital. . .I'd be fine on my own. I don't need any property or — well, I'd manage. I always have. I only enjoy spending time with you, it's not about your apartment or —" she paused, waiting to see if he was really listening. His mouth twitched a bit, his eyes now searching her face wildly. She sighed, letting her gaze fall. "I understand. Truly, I do Charles. You don't want to be stuck with me."

"But that's the point," he breathed, "_I do want to be stuck with you._"

She looked up, her eyes boring into his, a realization flooding over her: his apprehension and tension, his uncertainty, his edginess, "I'm not sure I can be hearing this right."

"You are. . .if you think . . .I'm asking you to marry me."

She nearly dropped the glasses and the only thing keeping them safely in her grasp was the way all the muscles in her body suddenly clenched, her chest grasping her heart so that it wouldn't beat out of her chest, her lungs storing her breath away where she could no longer get to it. Her head began to spin and she felt an ache in her throat, behind her eyes, as she looked at him, unspeaking.

"I won't pressure you — you can take some time to think about it but I know this much: _I'm_ not marrying anyone else." he said, a small smile creeping across his face for the first time in what felt like so long.

"Charles," she breathed, "Are you_ sure_?"

He swallowed, "I am but — if you're not—?"

"No, you misunderstand I just — at our age, what's left of me for you? I can't imagine you. . .that I could hope to _please_ you . . .an old trout. . ."

"Elsie, I have never been more sure of _anything_ in my entire life."

She hesitated, looking up at him, her eyes wide, "I . . .well, if you're _sure_. . ." He gently grazed her cheek with his palm, letting his fingers settle into her hair. She smiled, looking up at him from beneath her eyelashes, "If you want me, you can have me," she whispered, "Warts and all, as they say. . ."

Both their eyes gone damp, he leaned down, taking a breath as his lips hovered before hers, inhaling the sweet scent of the perfume he knew she dabbed behind her ear, the faint taste of cider on her lips as his touched their softness. His hands at either side of her face, he smiled against her mouth as she deepened the kiss, throwing her arms up upon his shoulders, her fingers dangling at the nape of his neck.

Upstairs, the piano rang its final chord and applause filled the air.

When he broke away, he kissed her forehead tenderly before folding her into an embrace, laying her head perfectly at the height of his racing heart.

Perhaps for the first time in her life— as she let her eyes flutter closed, a sweet little grin tugging at her lips— Elsie understood the merits of high heeled shoes.


	37. EPILOGUE

**A/N: **Sometimes I can't believe this story happened, or that you all came along on the journey with me. I know we didn't get to see all the places the story could go, or meet all the patients who had stories to tell, and that's why I'm only calling it "done" for now. I'll leave the door open – a sequel, some drabbles somewhere down the line. But please know that this AU, this story and_ each and every one of you_ — will stay with me.

For those that have loyally followed here and on Tumblr, when I was there for a time, I thank you. You have no idea how much of an impact you had on me not just as a writer and a fangirl, but a human being. I have made some truly irreplaceable friends in this fandom. I also cherish your insights, your commentary, your joy and struggles with this and _all _my fics, and I hope that you can read and re-read this fic and still cherish it. Nothing would make me happier than to know that I live on, somehow, in this crazy modern AU that captivated me just as much as it captivated you.

Some of you know that I'm off into the wild blue yonder — I've got a literary agent, next month it's off to see publishers— it's moving faster than I ever could have anticipated. Only sad it's for a project that isn't in any way related to fanfic, ha! While I'm terribly excited about what the future might hold for me, I can easily say that it won't likely hold a candle to the fun I've had with all of _you_.

I do hope that if you're so inclined, you'll keep up with me. Sheepishly hoping maybe a few of you will buy my book! But in the meantime, please enjoy the epilogue to this story.

The end—for now.

But as you know, just as it's time to say goodbye to Downton, the hospital here is always a place you can come back to.

Downton Hospital is truly never far from your reach. And even though we're left with a lot of unanswered questions, some plots that fell away — that's the nature of life, particularly in a hospital. But just know that one day, if we're called, we'll come back and walk the halls together.

It's been a privilege. Thank you for taking this incredible, incomparable journey with me.

You've made me a better writer, a better patient — and a better human.

With all my love,

**Doc**

* * *

They'd disappeared into the cold night air. Off in the distance a church bell rang, striking midnight, and she stopped short, sliding along the icy pavement. He laughed, stuffing her ungloved hands into the pockets of his coat. She hushed him, then looked up, snowflakes wetting her eyelashes.

"Do you hear any reindeer?" she whispered, her breath a warm plume that tickled her nose.

"I think we'll miss Santa entirely," he said, feigning a concerned glance, "My poor old Volkswagen is no match for eight steroid-infused reindeer."

She laughed at this — _really_ laughed, tipping her head back, the beautiful sound cascading up into the dark sky. He wrapped his arms around her waist, pulling her tighter and kissing her neck, his hand tangling in her hair and pushing her hat off her head and into the snowbank at their feet.

"_Charles_," she said, grinning against his mouth. He stopped, pulling back and blinking little icy flakes from his eyes. She bit her lip, a little pinch of white on the plushy red, "_My ears are cold_."

He chuckled, reaching up and covering them with his mitts, shaking her head gently before kissing her again. The streets around them were empty, no sound but that of the crinkling of the snow beneath their feet as they fell into one another's orbit.

She lifted her hands from within his pockets, reaching down to grab her hat and then popping back up, taking his hand in hers and leading him toward the car. Breathless, they both practically fell into their seats. He started the engine, cranking the heat up and the car groaned to life. The radio clicked on, startling them both.

_I really can't stay, _

_baby it's cold outside._

"Well, _there's_ a classic," Charles said, clearing his throat, "Fancy a duet?"

Elsie smirked, shaking her head — but she hit the next verse, right in her key.

_"Maybe just a half a drink more. . ." _

They both giggled, realizing that of course they both knew the all the words — especially this time of year when it was a Christmas station staple. What they hadn't anticipated was their harmony — the way their voices blended together so deliciously, so effortlessly.

He threw the car into park outside his flat, letting the song finish before turning the key. He looked at her for a moment in the dark, trying to make out the expression she wore in the moonlight.

"I hope. . .if we. . ." he tried, the keys jangling against his fingers, "You'd like to. . .?"

"Oh _Charles_," she breathed, letting her head loll back against the headrest, "I thought you'd never ask."

* * *

He closed the door to his bedroom, which was somewhat strange and perfunctory a thing for him to do in his own house, where no one would disrupt them. Still, to him, it felt somehow befitting of the moment. A customary way to solidify their intentions.

They'd both shed their coats and boots, but she sat on his bed, still nestled in her frilly blouse and sweater from the evening, he much in need of having his shirt and tie removed. He took a few soundless steps toward the bed, his hand rising up before him, as if guided to her, and gently slid beneath the shoulder of her sweater, pushing it down. Without taking her eyes from his, she reached up to begin to unbutton her blouse. Kneeling before her, letting his hands walk up the sides of her thighs, he undid her stockings, carefully rolling them down each smooth leg.

"I didn't think women still wore garters," he said, momentarily puzzled, "But I must say — _I thank you_."

"Pantyhose are wretched things," she said, reaching up to undo her chignon. Her hair fell down softly around her shoulders, a few tendrils falling across her lips. She felt his gaze hanging on her and suddenly she grew nervous. Was she showing her age? She self-consciously pulled her shirt tight in front of chest, "We don't _have_ to —"

"I know you're nervous. I know you feel old. _So do I_," he confessed, gently rubbing the tops of her thighs, "And maybe we _are_ — but to me, you are beautiful. And I want to be as close as two people can be for whatever time we have left."

She felt a tear escape, cascading down her flushed cheeks, and she blinked furtively. He leaned forward, kissing her softly at the corner of her mouth first, then along her cheek, tightening his grasp of her thighs. She rose up against him, letting her hands fall away, her blouse opening to him. He pulled back, letting his hands emerge from beneath her skirt (which she hastily unzipped). He stopped short at the sound of it, swallowing a laugh.

"Do you remember that night, in the ICU, with your skirt and — and I—"

"Oh God, _yes_, I do." she breathed, her cheeks pinking up, "I thought you were trying to cop a feel." She looked at him now, clearly aroused in every speakable and unspeakable way for her.

"I . . .I thought you'd just come back from. . .from being with someone. That perhaps you —"

"_Oh God,_" she said, her eyes wide, "No. _Never_." She lifted her hands, taking his face between them, "It's only ever been you."

"_Really?_" he said, his voice cracking a bit with either relief or disbelief, perhaps both at the late hour.

"_Yes_," she breathed, "My body knew even when my mind didn't. _The heart is a lonely hunter_, to quote Carson McCul—"

He rose up, kissing her squarely and pushing her back against the bed. She gasped against his mouth, letting him unfasten her bra as she wriggled out of her panties and garter. He discarded his shirt first, and the snap of his belt against the buckle made something begin to thrum deep inside of her. Metal against leather some sort of bewitching siren song.

"I don't know that I have much to offer you besides my love," he panted, gently caressing a fallen strand of hair from her face, "But this. . ._this_ is a privilege, Elsie Hughes."

She tipped her head, watching him for a long moment as he covered her breast — the scar, the mangled horrible thing — with his gentle hand.

"Looks better than the last time you saw it," she whispered, offering him a small smile, "They weren't so bad, you know. Once upon a _youth_. . ."

"I have a rather reverent affection for this breast," he said, running the pad of his thumb over her nipple, "The first time I ever saw it . . .held it in my hand. . .it was an enemy that might well have taken you from me. A dragon I could slay. But I kept you safe. I made you well. You came back to me, Elsie, and this scar — while you think it unsightly — is a testament to your strength. Healing can't occur in dead tissue. A scar such as this is more proof of your vitality than your years."

She sighed, her chest heaving against him.

"Charles Carson, your words are endearing but I'm a woman of science. I need _proof._" She laced her hands around his neck, pulling him down, pressing him against her bare skin, whispering playfully in his ear, "_So show me_."

* * *

"Did you put Dad to bed?" Sybil laughed, closing the dishwasher with her foot as she turned to face her mother. Stepping into the kitchen, Cora yawned, nodding.

"We'll have to let him sleep in tomorrow," she said, folding her arms in front of her chest, warming them with her hands, "At least you girls are all grown up now and won't be clambering into our bed at 4 am. . ."

"Don't be so sure," Sybil said, crossing the kitchen to wrap her arms around her mum.

"I'll fill your entire _bed _with coal if you even so much as _think_ about it," Cora laughed, kissing Sybil's cheek.

"Mary's gone back to her flat and Edith drove Roz home. They said they'll meet us at Granny's in the afternoon."

"Thank you for all your help, really. I'm sure you'd've much rather done . . .well,_ anything else,_ frankly."

"I had fun, Mum."

"Good," Cora sighed, looking around at the mostly cleaned up kitchen. Her life here, with the girls, with Robert working late nights, had always been "good enough" — she wasn't the kind of housewife Violet Crawley had envisioned, and as the years went by, she realized she'd never set out to be.

"I've got a gift for you _now, _though." Sybil said, taking her mother's hand and leading her into the den, where their sparkling Christmas tree towered over the room.

"Oh, Sybbie! Shouldn't we wait until tomorrow?"

"_No_," Sybil said firmly, "This one is special."

She scooted under the tree's branches, emerging a bit pine-sticky, but beaming. She handed her mother a rectangular parcel and a simple notecard.

"Open the card first." Sybil instructed, pulling Cora down to the floor with her.

Cora eyed her, meticulously opening the envelope and squinting at it a moment before her face lit up.

"Oh — Sybbie, darling!" she said, tearing up a bit, "Oh, this is — I can't believe you remembered."

"Mum, how could I forget? You divulged this — _hidden_ part of yourself to me. And I'm serious. I want you to get that back. Not for me or Dad — just for you."

Cora looked down at the card, which included a semester's worth of painting classes at the University. She felt the package in her other hand and could only guess.

Unwrapping it, she did burst into tears. A brand new set of oils. She hadn't had them in ages.

"All of this on _one _condition, Mum." Sybil said, wrapping her arms around her mother's shoulders.

"What, my darling?" Cora sniffled, reaching up to push the hair from Sybil's face.

"Your first painting. . ." she whispered, her smile breaking through, "_Must be of_ _me!"_

* * *

"Dr. Carson and Dr. Hughes took off in rather a hurry," John said, tossing back the covers and crawling into Anna's bed. She pushed back, nestling against him, sighing as he wrapped his arms around her waist.

"I hope it's because they've finally confessed their love to one another and they went squealing off into the night to consummate it," Anna laughed, tucking her toes between John's feet.

"About that. . ."

"Hm?"

"Are we ever going to tell anyone that _we_ got married?"

She rolled over onto her back, one arm slung up above her head.

"I don't know," she shrugged, "I rather like that it's been our little secret."

He nodded, "It's nice to have one when, of course, Downton tends to squeeze them all out of you. . ."

"We have_ two_, actually."

John furrowed his brow, "Oh?"

"But it won't be our secret for much longer," Anna grinned, her eyes sparkling. "John — I'm_ pregnant_."

* * *

"Alright, alright — what about_ this_ one?" Violet said, waving a card in front of Isobel's face as they road in the backseat of the town car, traversing London's snowy streets.

Isobel squinted at it in the dark, "Damned if I know. . ."

"Excuse me, sir?" Violet said, pushing her face between the seats to address the driver, "Do you know what — _flying sex snakes_—means?"

Isobel guffawed, slapping Violet's thigh, "Stop it —_ stop,_ he'll drive us off the road, mercifully killing us all!"

Managing to pull Violet back against the seat, Isobel just shook her head. A moment or two later, Violet's laugh roared up next to her.

"Oh! Here we go. Give this one to Richard the next time you see him."

Isobel took the card, giving Violet a look before glancing down at it.

_Friends with benefits._

* * *

Tony Gillingham sat in this empty flat, finishing off a bottle of merlot he'd opened a few hours ago and looking out over the city. London was mostly quiet, a few twinkling lights left on. Snow drifting softly beneath street lights. He sighed, patting his breast pocket for a cigarette, before turning and heading back to his desk.

An opened email. A blank response. His cursor blinking, an electronic taunt.

_Mr Gillingham,_

_I'm terribly sorry to send this on Christmas Eve, but I really do need your final decision. If we're to file a case, I'd prefer to do it before the new year. _

_You've all the evidence we collected. _

_It's up to you now._

He thought about Mary Crawley's cool rejection a few weeks earlier. About Downton, and all that they stood to lose. The wrongs that should be made right. About Alex Green— a man he'd hardly known really—dead in their emergency room for days before anyone knew. He thought about how really, Tony couldn't be certain he knew himself any better than he'd known Green.

He took a long drag off his cigarette, downed the last of his wine, and let his hands hover shakily over the keyboard.

As the first light of Christmas day rose up above the skyline, all that was heard was the steady _clickety-clack_ of his fingers against the keys, and if he were a younger man— a different man—maybe he'd've mistaken it for hoofbeats on the roof.


End file.
